Randomised clinical trial of synbiotic therapy in elective surgical patients

Anderson, A. D. G.; McNaught, C. E.; Jain, P. K.; MacFie, J.
February 2004
Gut;Feb2004, Vol. 53 Issue 2, p241
Academic Journal
Background: It is possible to manipulate the composition of the gastrointestinal microflora by administration of pre- and probiotics. This may help to preserve gut barrier function and reduce the incidence of septic morbidity. Aims: To assess the effects of a combination of pre- and probiotics (synbiotic) on bacterial translocation, gastric colonisation, systemic inflammation, and septic morbidity in elective surgical patients. Patients: Patients were enrolled two weeks prior to elective abdominal surgery. Seventy two patients were randomised to the synbiotic group and 65 to the placebo group. Patients were well matched regarding age and sex distribution, diagnoses, and POSSUM scores. Methods: Patients in the synbiotic group received a two week preoperative course of Lactobacillus acidophilus La5, Bifidobacterium lactis Bb-12, Streptococcus thermophilus, and Lactobacillus bulgaricus, together with the prebiotic oligofructose. Patients in the placebo group received placebo capsules and sucrose powder. At surgery, a nasogastric aspirate, mesenteric lymph node, and scrapings of the terminal ileum were harvested for microbiological analysis. Serum was collected preoperatively and on postoperative days 1 and 7 for measurement of C reactive protein, interleukin 6, and antiendotoxin antibodies. Septic morbidity and mortality were recorded. Results: There were no significant differences between the synbiotic and control groups in bacterial translocation (12.1% v 10.7%; p = 0.808, χ²), gastric colonisation (41 % v 44%; p = 0.719), systemic inflammation, or septic complications (32% v 31%; p =0.882). Conclusions: In this study, synbiotics had no measurable effect on gut barrier function in elective surgical patients. Further studies investigating the place of pre- and probiotics in clinical practice are required.


Related Articles

  • Laparotomy attenuates lipopolysaccharide-induced gastric bleeding in the rat. Ward, Jeremy L.; Delano, Benjamin A.; Adams, Sasha D.; Mercer, Elizabeth E.; Mercer, David W. // Digestive Diseases & Sciences;Apr2010, Vol. 55 Issue 4, p902 

    Lipopolysaccharide (LPS) increases systemic inflammation and causes duodenogastric reflux of bile and gastric bleeding. Laparotomy prevents gastric injury from the luminal irritant bile, but its effects on LPS-induced gastric injury are unknown. We hypothesized that laparotomy would diminish...

  • Heterotopic pancreas in children: review of the literature and report of 12 cases. Ogata, Hiromi; Oshio, Takehito; Ishibashi, Hiroki; Takano, Shuichi; Yagi, Minoru // Pediatric Surgery International;Mar2008, Vol. 24 Issue 3, p271 

    Heterotopic pancreas (HP) is rarely recognized during surgery. Many reports concerning this anomaly are simple case reports. We herein review our experiences with HP. We retrospectively investigated cases of HP from April 1975 to September 2006. We discussed the frequencies in the laparotomized...

  • Diclofenac.  // Reactions Weekly;8/1/2009, Issue 1263, p16 

    The article describes the case of a 73-year-old man who acquired diaphragm disease of the jejunum. The patient developed the condition while undergoing treatment with diclofenac and indometacin. During exploratory laparotomy, it was found that the patient had constricted bowel in the proximal...

  • Gastric cancer surgery without drains: a prospective randomized trial. Kim, Junuk; Lee, Junho; Jin Hyung, Woo; Ho Cheong, Jae; Chen, Jian; Ho Choi, Seung; Hoon Noh, Sung // Journal of Gastrointestinal Surgery;Sep2004, Vol. 8 Issue 6, p727 

    Prophylactic drain placement during major abdominal surgery has been widely practiced without clear scientific evidence to support it. We hypothesized that prophylactic drain placement is not necessary in gastric cancer surgery. A randomized prospective trial was conducted between February 1,...

  • Patients with Adenocarcinoma of the Small Intestine with 9 or More Regional Lymph Nodes Retrieved Have a Higher Rate of Positive Lymph Nodes and Improved Survival. Wilhelm, Alexander; Müller, Sascha; Steffen, Thomas; Schmied, Bruno; Beutner, Ulrich; Warschkow, Rene; Müller, Sascha A; Schmied, Bruno M // Journal of Gastrointestinal Surgery;Feb2016, Vol. 20 Issue 2, p401 

    Purpose: To assess the influence of regional lymph node (RLN) retrieval on stage migration of adenocarcinoma of the small intestine and survival.Patients and Methods: From the Surveillance, Epidemiology, and End Results database,1090 patients with nonmetastatic small...

  • The spread of metastatic lymph nodes to the mediastinum from left upper lobe cancer: results of superior mediastinal nodal dissection through a median sternotomy Sakao, Yukinori; Miyamoto, Hideaki; Yamazaki, Akio; Ou, Shiaki; Shiomi, Kazu; Sonobe, Satoshi; Sakuraba, Motoki // European Journal of Cardio-Thoracic Surgery;Sep2006, Vol. 30 Issue 3, p543 

    Abstract: Background: This study endeavored to clarify the location, frequency, and prognostic value of metastatic lymph nodes in the mediastinum among patients with left upper lung cancer who underwent complete dissection of the superior mediastinal lymph node through a median sternotomy....

  • Role of Preoperative Plasma CA 15-3 and Carcinoembryonic Antigen Levels in Determining Histopathologic Conventional Prognostic Factors for Breast Cancer World J. Surg. Vol. 27, No. 5, May 2003. Seker, Duray; Kaya, Oskay; Adabag, Aysegul; Necipoglu, Gaye; Baran, Ismet // World Journal of Surgery;May2003, Vol. 27 Issue 5, p519 

    Breast cancer is one of the leading causes of cancer death among women all over the world, with about one million new breast cancer cases diagnosed per year. This large number of cases make the diagnosis, treatment, and determination of the factors affecting the survey extremely important. The...

  • lymphadenitis.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p1374 

    A definition of the term "lymphadenitis" is presented, which refers to the inflammation of lymph nodes through various means, including phagocytes, cancer cells, and antigenic material.

  • adenitis.  // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p46 

    A definition of the term "adenitis," which refers to inflammation of lymph nodes or a gland, is presented.


Read the Article


Sign out of this library

Other Topics