Chapter 12 - Probiotics and Prebiotics: Role in Surgery Recuperation?

Abstract

This chapter discusses the role of probiotics and prebiotics in surgery recuperation. The combination of pre- and probiotics is called “synbiotics.”Synbiotics is defined as a mixture of prebiotics and probiotics that beneficially affects the host by improving the survival and implantation of live microbial dietary supplements in the gastrointestinal tract, by selectively stimulating the growth and activating the metabolism of one or a limited number of health-promoting bacteria, thus improving host welfare. In the surgical field, the association of probiotics and prebiotics seems reasonable because of their synergic effect at the mucosal barrier setting. This chapter provides the evidence that comes out of controlled randomized trials to prescribe synbiotics to surgical patients, mainly those in the trauma setting, and those candidates to elective biliary and liver resection, liver transplantation, and pancreatic resection. However, in colorectal operations, the usefulness of synbiotics is less appreciable. Randomized trials using synbiotics by enteral route versus controls seem to be associated with a more significant decrease in infectious morbidity rate than trials in which synbiotics were administered orally. As the effect of synbiotics depends on the strains, the concentration of probiotics, and the duration of the therapy, further studies are necessary.