Abstract
Background
The objective is to elucidate the effects of oral bifid triple viable probiotics among
patients with colorectal cancer.
Methods
Sixty patients undergoing radical colorectal resection were randomly assigned to 3-day
(days −5 to −3) preoperative probiotics (group A, n=30) or placebo (group B, n=30) treatment. The alteration of intestinal flora was evaluated by fecal cultures
of Escherichia coli, Bifidobacterium longum and intestinal fungi; the gut barrier function by serum endotoxins and D-lactic acids
and the immune and stress responses by peripheral blood immunoglobins, interleukin-6
and C-reactive protein. Postoperative infections were documented physically, radiologically
and microbiologically.
Results
Inverted Bifidobacterium/Escherichia ratios were preoperatively and postoperatively present in group B (both P<0.05). Bifidobacterium counts increased significantly, whereas Escherichia counts decreased significantly on postoperative days 3 to 5 (P<0.05), along with reversing the Bifidobacterium/Escherichia ratio inversion until postoperative days 3 to 5 in group A. Group A also had lower
levels of endotoxins, D-lactic acids, serum interleukin-6 and C-reactive protein but
higher levels of serum IgG and sIgA (all P<0.05) than group B. The incidences of postoperative infectious complications were
3.3% to 6.7% and 3.3% to 30% in groups A and B (overall, 10.0% versus 33.3%, P<0.05), respectively.
Conclusion
The preoperative oral bifid triple viable probiotics minimize the postoperative occurrence
of infectious complications, with possible mechanisms attributed to the maintenance
of the intestinal flora and restriction of bacterial translocation from the intestine.
It was representative of the enhancement of systemic/localized immunity and concurrent
attenuation of systemic stress response.
Key Indexing Terms
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Article Info
Publication History
Accepted:
June 15,
2011
Received:
November 23,
2010
Footnotes
This study was supported by grants from the Shanghai Municipal Department of Health (2006045) and the Science and Technology Department of Zhejiang Province (2008C33039).
Ji-Wei Zhang, Peng Du and Jun Gao contributed equally to this work.
Identification
Copyright
© 2012 Southern Society for CLinical Investigation. Published by Elsevier Inc. All rights reserved.
