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Pre-surgical Administration of Microbial Cell Preparation in Colorectal Cancer Patients: A Randomized Controlled Trial

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Abstract

Introduction

Disruption of normal gut function is a common side effect post abdominal surgery. It may result in reduced tolerance to oral nutrition and progress to postoperative ileus. Microbial cell preparation is beneficial as a pre-surgical nutritional supplement to aid in bowel recovery and promote the return of normal gut function following abdominal surgery. The aim of this study was to evaluate the efficacy of pre-surgical administration of microbial cell preparation in promoting the return of normal gut function.

Method

The study is a randomized, double-blind, placebo-controlled trial. In total, 40 patients were recruited. Patients were randomized to receive either microbial cell preparation (n = 20) or placebo (n = 20) for 7 days prior to elective surgery. The primary end point was the time to return of normal gut function, while the secondary end point was the duration of hospital stay.

Results

The treatment group demonstrated significantly faster return of normal gut function with a median of 108.5 h (80–250 h) which was 48 h earlier than the placebo group at a median of 156.5 h (94–220 h), p = 0.022. The duration of hospital stay in the treatment group was also shorter at a median of 6.5 days (4–30 days), in comparison to the placebo group at 13 days (5–25 days), p = 0.012.

Conclusion

Pre-surgical administration of microbial cell preparation promotes the return of normal gut function in patients after colorectal cancer surgery, thus associated with faster recovery and shorter duration of hospital stay.

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References

  1. Shibata Y, Toyoda S, Nimura Y (1997) Patterns of intestinal motility recovery during the early stage following abdominal surgery: clinical and manometric study. World J Surg 21(8):806–810. doi:10.1007/s002689900310

    Article  CAS  PubMed  Google Scholar 

  2. Holte K, Kehlet H (2000) Postoperative ileus: a preventable event. Br J Surg 87(11):1480–1493

    Article  CAS  PubMed  Google Scholar 

  3. Livingston EH, Passaro EP Jr. (1990) Postoperative ileus. Dig Dis Sci 35(1):121–132

    Article  CAS  PubMed  Google Scholar 

  4. Behm B, Stollman N (2003) Postoperative ileus: etiologies and interventions. Clin Gastroenterol Hepatol 1:71–80

    Article  PubMed  Google Scholar 

  5. Health Care Financing Administration: Federal Register (1999–2000). http://www.gpoaccess.gov/fr/. Accessed 1 May 2008

  6. Bengmark S, Gil A (2006) Bioecological and nutritional control of disease: prebiotics, probiotics, and synbiotics. Nutr Hosp 21:72–84

    CAS  PubMed  Google Scholar 

  7. Mitsuoka T (2000) Significance of dietary modulation of intestinal flora and intestinal environment. Biosci Microflora 9:15–25

    Article  Google Scholar 

  8. Lilly DM, Stillwell RH (1965) Probiotics: growth promoting factors produced by microorganisms. Science 147:747–748

    Article  CAS  PubMed  Google Scholar 

  9. Gatt M (2008) Gut failure: diagnosis and management. MD dissertation, University of Hull, Hull

  10. Liu Z, Qin H, Yang Z et al (2011) Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery—a double-blind study. Aliment Pharmacol Ther 33(1):50–63

    Article  CAS  PubMed  Google Scholar 

  11. Jayasimhan S, Yap NY, Roest Y et al (2013) Efficacy of microbial cell preparation in improving chronic constipation: a randomized, double-blind, placebo-controlled trial. Clin Nutr 32(6):928–934. doi:10.1016/j.clnu.2013.03.004

    Article  PubMed  Google Scholar 

  12. Frankenfield DC, Muth ER, Rowe WA (1998) The Harris–Benedict studies of human metabolism: history and limitations. J Am Diet Assoc 105(8):439–445

    Article  Google Scholar 

  13. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed  PubMed Central  Google Scholar 

  14. Woodcock NP, Zeigler D, Palmer MD et al (2001) Enteral versus parenteral nutrition: pragmatic study. Nutrition 17:1–12

    Article  CAS  PubMed  Google Scholar 

  15. Gatt M, Anderson AD, Reddy BS et al (2005) Randomized clinical trial of multimodal optimization of surgical care in patients undergoing major colonic resection. Br J Surg 92:1354–1362

    Article  CAS  PubMed  Google Scholar 

  16. Jeppsson B, Mangell P et al (2011) Use of probiotics as prophylaxis for postoperative infections. Nutrients 3:604–612

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hautemaniere A, Florentin A, Hunter PR et al (2013) Screening for surgical nosocomial infections by crossing databases. J Infect Pub Health 6:89–97

    Article  Google Scholar 

  18. Sugawara G, Nagino M, Nishio H et al (2006) Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: a randomized controlled trial. Ann Surg 244:706–714

    Article  PubMed  PubMed Central  Google Scholar 

  19. Rayes N, Seehofer D, Theruvath T et al (2007) Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial. Ann Surg 246:36–41

    Article  PubMed  PubMed Central  Google Scholar 

  20. Kanazawa H, Nagino M, Kamiya S et al (2005) Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbeck’s Arch Surg 390:104–113

    Article  Google Scholar 

  21. Qin HL, Zheng JJ, Tong DN et al (2008) Effect of Lactobacillus plantarum enteral feeding on the gut permeability and septic complications in the patients with acute pancreatitis. Eur J Clin Nutr 62:923–930

    Article  CAS  PubMed  Google Scholar 

  22. Borchers AT, Selmi C, Meyers FJ et al (2009) Probiotics and immunity. J Gastroenterol 44(1):26–46

    Article  PubMed  Google Scholar 

  23. Rayes N, Seehofer D, Hansen S et al (2002) Early enteral supply of Lactobacillus and fiber versus selective bowel decontamination: a controlled trial in liver transplant recipients. Transplantation 74:123–128

    Article  PubMed  Google Scholar 

  24. McNaught CE, Woodcock NP, MacFie J et al (2002) A prospective randomized study of the probiotic Lactobacillus plantarum 299 V on indices of gut barrier function in elective surgical patients. Gut 51:827–831

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Nomura T, Tsuchiya Y, Nashimoto A et al (2007) Probiotics reduce infectious complications after pancreaticoduodenectomy. Hepato-gastroenterology 54:661–663

    PubMed  Google Scholar 

  26. Rayes N, Seehofer D, Theruvath T et al (2005) Supply of pre and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant 5:125–130

    Article  PubMed  Google Scholar 

  27. Anderson ADG, McNaught CE, Jain PK et al (2004) Randomised clinical trial of synbiotic therapy in elective surgical patients. Gut 53:241–245

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Aguilar-Nascimento JE, Prado S, Zaffani G et al (2006) Perioperative administration of probiotics: effects on immune response, anastomotic resistance and colonic mucosal trophism. Acta Ciru Bras 21(4):80–83

    Article  Google Scholar 

  29. Diepenhorst GM, van Ruler O, Besselink MG et al (2011) Influence of prophylactic probiotics and selective decontamination on bacterial translocation in patients undergoing pancreatic surgery: a randomized controlled trial. Shock 35:9–16

    Article  PubMed  Google Scholar 

  30. Gianotti L, Morelli L, Galbiati F et al (2010) A randomized double-blind trial on perioperative administration of probiotics in colorectal cancer patients. World J Gastroenterol 16(2):167–175

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Liu ZH, Huang MJ, Zhang XW et al (2013) The effects of perioperative probiotic treatment on serum zonulin concentration and subsequent postoperative infectious complications after colorectal cancer surgery: a double-center and double-blind randomized clinical trial. Am J Clin Nutr 97(1):117–126

    Article  CAS  PubMed  Google Scholar 

  32. Liu Z, Li C, Huang M et al (2015) Positive regulatory effects of perioperative probiotic treatment on postoperative liver complications after colorectal liver metastases surgery: a double-center and double-blind randomized clinical trial. BMC Gastroenterol 15:34

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

The authors would like to express their gratitude to B-Crobes Laboratory Sdn. Bhd for sponsoring the research samples (microbial cell preparation and placebo). This study was supported by a grant from B-Crobes Laboratory Sdn. Bhd.

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Authors

Corresponding author

Correspondence to Kin Fah Chin.

Additional information

Registered in Australian New Zealand Clinical Trials Registry: ACTRN12615000545561.

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Tan, C.K., Said, S., Rajandram, R. et al. Pre-surgical Administration of Microbial Cell Preparation in Colorectal Cancer Patients: A Randomized Controlled Trial. World J Surg 40, 1985–1992 (2016). https://doi.org/10.1007/s00268-016-3499-9

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  • DOI: https://doi.org/10.1007/s00268-016-3499-9

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