Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy

Abstract

Synbiotics, combined with early enteral nutrition, can reduce postoperative infections. This beneficial effect presumably involves correction of an intestinal microbial imbalance induced by surgical stress.

Does the use of probiotics/synbiotics prevent postoperative infections in patients undergoing abdominal surgery? A meta-analysis of randomized controlled trials

“…The food supplements containing both probiotics and prebiotics are called synbiotics [16]. Several randomized controlled trials (RCTs) using probiotics/synbiotics preoperative and/or postoperative with a focus on the prevention of postoperative infections [17][18][19][20][21][22][23][24][25][26] have been performed, and a narrative review has been published [27].…”

Synbiotic Therapy Reduces the Pathological Gram-Negative Rods Caused by an Increased Acetic Acid Concentration in the Gut

“…We confirmed that the majority of the Lactobacillus in 14 the gut was L. casei strain Shirota after the symbiotic therapy. Although we did not have a method to confirm the strain of Bifidobacterium, a previous study, which used the same synbiotics as our study, demonstrated that B. breve strain Yakult reached the same level as L. casei strain Shirota after symbiotic therapy [4,5]. Another previous study, which used L. casei strain Shirota and galactooligosaccharides as synbiotics, showed that there was an increase of endogenous Bifidobacterium in the gut without an administration of exogenous Bifidobacterium [23,24].…”

“…Previous reports have described the effects of probiotics/synbiotics for general infectious complications in various patients, such as liver transplantation [1,2], major abdominal surgery [3][4][5], severe acute pancreatitis [6][7][8], trauma [9,10], and critically ill patients [11][12][13]. However, these reports generally did not examine changes in the gut flora following probiotic/synbiotic therapy [1][2][3][6][7][8][9][10][11][12].…”

Synbiotics, Surgical Infection and Colonization Resistance

“…The efficacy of perioperatively administered synbiotics was not validated as a treatment to reduce the incidence of infectious complications after surgery. In previous studies of hepatobiliary, pancreatic, and esophageal surgery, usefulness of synbiotics/probiotics as prophylaxis has been described in the context of bacterial translocation (BT), associated with an altered intestinal barrier and immune function [8][9][10][11][23][24][25]. The conditions for use of prophylactic agents in the colon and rectum may, however, be different.…”

“…The therapeutic effects of probiotic administration on disorders presumably associated with dysbiosis have been extensively examined [1][2][3][5][6][7]. Several randomized controlled trials, including pancreatoduodenectomy, hepatobiliary resection and liver transplantation, demonstrate that the use of probiotics in patients undergoing abdominal surgery is a promising approach to the prevention of post-operative infectious complications [8][9][10][11]. Nevertheless, the effectiveness of probiotics treatment for prevention of infectious complications after colorectal surgery remains inconclusive [1,3,[12][13][14][15][16][17][18][19][20][21], possibly due to differences in patient groups, varying preparations of probiotics, and heterogeneity in the quality of methods.…”