Abstract
This study was designed to mainly evaluate the anti-infective effects of perioperative probiotic treatment in patients receiving confined colorectal cancer (CRC) respective surgery. From November 2011 to September 2012, a total of 60 patients diagnosed with CRC were randomly assigned to receive probiotic (n = 30) or placebo (n = 30) treatment. The operative and post-operative clinical results including intestinal cleanliness, days to first - flatus, defecation, fluid diet, solid diet, duration of pyrexia, average heart rate, length of intraperitoneal drainage, length of antibiotic therapy, blood index changes, rate of infectious and non-infectious complications, postoperative hospital stay, and mortality were investigated. The patient demographics were not significantly different (p > 0.05) between the probiotic treated and the placebo groups. The days to first flatus (3.63 versus 3.27, p = 0.0274) and the days to first defecation (4.53 versus 3.87, p = 0.0268) were significantly improved in the probiotic treated patients. The incidence of diarrhea was significantly lower (p = 0.0352) in probiotics group (26.67%, 8/30) compared to the placebo group (53.33%, 16/30). There were no statistical differences (p > 0.05) in other infectious and non-infectious complication rates including wound infection, pneumonia, urinary tract infection, anastomotic leakage, and abdominal distension. In conclusion, for those patients undergoing confined CRC resection, perioperative probiotic administration significantly influenced the recovery of bowel function, and such improvement may be of important clinical significance in reducing the short-term infectious complications such as bacteremia.
Highlights
The amount of gut microbes, which may be nearly 10 times as many as host cells, fluctuates frequently and severely under the circumstances of many gut diseases, such as obesity, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and even colorectal cancer (CRC) [1, 2]
Dysbiosis of gut bacteria generally occurs in cancer tissues which are directly exposed to microbes, such as colon and rectum [3, 4]
There were no significant differences with regard to gender (p = 0.604), age (p = 0.567), body mass index (BMI) (p = 0.895), tumor location (p = 0.855), TNM stage (p = 0.771), and tumor differentiation (p = 0.707) between the probiotics and the placebo groups
Summary
The amount of gut microbes, which may be nearly 10 times as many as host cells, fluctuates frequently and severely under the circumstances of many gut diseases, such as obesity, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), and even colorectal cancer (CRC) [1, 2]. Dysbiosis of gut bacteria generally occurs in cancer tissues which are directly exposed to microbes, such as colon and rectum [3, 4]. Recent studies confirmed the tight relationship between the microbiota imbalance and cancer progression [5,6,7]. Postoperative infection is a poor indicator for surgical treatment of cancer [9]. It occurs by a numbers of www.impactjournals.com/oncotarget internal and external causes. Inappropriate use of antibiotics, chemotherapy, or even mechanical bowel preparation for patients undergoing confined colorectal cancer (CRC) resection operation, could lead to microecological imbalance, subsequently exacerbating the risk for various infections [11].
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