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Efficacy of perioperative synbiotics treatment for the prevention of surgical site infection after laparoscopic colorectal surgery: a randomized controlled trial

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Abstract

Purpose

The aim of this study was to assess the effect of perioperative oral administration of synbiotics on the surgical outcome in patients undergoing laparoscopic colorectal resection.

Methods

In this single-center randomized, controlled trial, patients scheduled to undergo elective laparoscopic colorectal surgery were eligible to participate and randomly assigned to a synbiotics group or a control group. The primary study outcome was the development of infectious complications, particularly surgical site infection (SSI), within 30 days of surgery.

Results

In this study, 379 patients were enrolled and randomly assigned (173 to the synbiotics group and 206 to the control group), of whom 362 patients (168 to the synbiotics group and 194 to the control group) were eligible for this study. SSI occurred in 29 (17.3 %) patients in the synbiotics group and 44 (22.7 %) patients in the control group (OR: 0.761, 95 % CI 0.50–1.16; p = 0.20). Overall, the rate of postoperative complications, including anastomotic leakage, did not differ significantly between the two groups. Synbiotics treatment reversed the changes in fecal bacteria and organic acids after surgery and suppressed the increases in potentially pathogenic species, such as Clostridium difficile.

Conclusion

The efficacy of perioperative administration of synbiotics was not validated as a treatment for reducing the incidence of infectious complications after laparoscopic colorectal resection. However, the microbial imbalance, in addition to the reduction in organic acids, could be improved by perioperative synbiotics treatment.

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Acknowledgments

This study was funded by the Yakult Central Institute for Microbiological Research. We wish to express our sincere gratitude to Norikatsu Yuki, Akira Takahashi and Yukiko Kado (Yakult Central Institute) for their valuable assistance in performing the microflora analyses.

Conflict of interest

S. Komatsu, E. Sakamoto, S. Norimizu, Y. Shingu, and M. Nagino have no conflicts of interest to declare. T. Asahara and K. Nomoto are researchers of Yakult Honsha Co., Ltd.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Aichi Medical University, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan

    Shunichiro Komatsu

  2. Department of Digestive Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Eiji Sakamoto, Shinji Norimizu & Yuji Shingu

  3. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan

    Masato Nagino

  4. Yakult Central Institute, Tokyo, Japan

    Takashi Asahara & Koji Nomoto

Authors
  1. Shunichiro Komatsu
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  2. Eiji Sakamoto
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  3. Shinji Norimizu
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  4. Yuji Shingu
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  5. Takashi Asahara
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  6. Koji Nomoto
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  7. Masato Nagino
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Correspondence to Shunichiro Komatsu.

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Komatsu, S., Sakamoto, E., Norimizu, S. et al. Efficacy of perioperative synbiotics treatment for the prevention of surgical site infection after laparoscopic colorectal surgery: a randomized controlled trial. Surg Today 46, 479–490 (2016). https://doi.org/10.1007/s00595-015-1178-3

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  • DOI: https://doi.org/10.1007/s00595-015-1178-3

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