Wiener klinische Wochenschrift

, Volume 122, Supplement 2, pp 26–30 | Cite as

Preoperative synbiotic bowel conditioning for elective colorectal surgery

  • Matjaž HorvatEmail author
  • Bojan Krebs
  • Stojan Potrč
  • Arpad Ivanecz
  • Lidija Kompan
Original article


BACKGROUND: Preoperative bowel cleaning for elective colorectal surgery is a routine procedure. Synbiotics (probiotics plus prebiotics) are known for their beneficial effects on gut immune function and maintenance of the gut barrier. The main purpose of this study was to replace preoperative mechanical bowel cleaning with synbiotics and to assess the systemic inflammatory response and clinical outcome in patients undergoing colorectal surgery. PATIENTS AND METHODS: A prospective double-blind randomized placebo-controlled trial was conducted in 68 patients. The first group of 20 patients received synbiotics, the second group of 28 patients prebiotics and heat-deactivated probiotics, and the third (control) group of 20 patients mechanical bowel cleaning prior to the operation. RESULTS: Significantly higher values of interleukin 6 (IL-6) were detected 72 h after the operation in the synbiotic group (P = 0.025), as well as an increase of fibrinogen at 24 h postoperatively (P = 0.030). No statistical differences were found in leukocytes count, C-reactive protein or the lymphocyte/granulocyte ratio. There were no differences in postoperative complications between the groups. Mean hospital stay was 9.2 days in the prebiotic group, 9.5 days in the control group, and 10.95 days in the synbiotic group. CONCLUSIONS: Preoperative administration of prebiotics in elective colorectal surgery appears to have the same protective effect in preventing a postoperative inflammatory response as mechanical bowel cleaning. Further prospective studies are needed to verify the effects of synbiotics.


Mechanical bowel cleaning Synbiotics Colorectal surgery Systemic inflammatory response 


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Copyright information

© Springer-Verlag 2010

Authors and Affiliations

  • Matjaž Horvat
    • 1
    Email author
  • Bojan Krebs
    • 1
  • Stojan Potrč
    • 1
    • 3
  • Arpad Ivanecz
    • 1
  • Lidija Kompan
    • 2
  1. 1.Department for Abdominal and General SurgeryClinic for Surgery, University Clinical Center MariborMariborSlovenia
  2. 2.Institute for OncologyLjubljanaSlovenia
  3. 3.Faculty of MedicineUniversity of MariborMariborSlovenia

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