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Erschienen in: Langenbeck's Archives of Surgery 2/2005

01.04.2005 | Original Article

Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy

verfasst von: Hidetoshi Kanazawa, Masato Nagino, Satoshi Kamiya, Shunichiro Komatsu, Toshihiko Mayumi, Kenji Takagi, Takashi Asahara, Koji Nomoto, Ryuichiro Tanaka, Yuji Nimura

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 2/2005

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Abstract

Background and aims

The clinical value of synbiotics in surgical patients remains unclear. The aim of this study was to investigate the effect of synbiotics on intestinal integrity and microflora, as well as on surgical outcome, in patients undergoing high-risk hepatectomy.

Methods

Fifty-four patients with biliary cancer were randomly allocated to two groups before hepatectomy. One group received postoperative enteral feeding that included synbiotics; the other received enteral feeding only. Lactulose/mannitol (L/M) ratio, serum diamine oxidase (DAO) activity, and fecal microflora and organic acid concentrations were determined. Postoperative infectious complications were recorded.

Results

Of the 54 patients, 44 completed the trial (21 receiving synbiotics and 23 others as controls). Postoperative changes in L/M ratios and serum DAO activities were identical between the two groups. Numbers of beneficial bacteria increased in the synbiotics group after surgery but decreased in controls. Numbers of harmful microorganisms decreased in the synbiotics group but increased in controls. Total organic acid concentrations increased in the synbiotics group but decreased in controls. Incidence of infectious complications was 19% (4/21) in the synbiotics group and 52% (12/23) in controls (P<0.05). All study patients tolerated surgery (mortality 0%).

Conclusions

Synbiotics, combined with early enteral nutrition, can reduce postoperative infections. This beneficial effect presumably involves correction of an intestinal microbial imbalance induced by surgical stress.
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Metadaten
Titel
Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy
verfasst von
Hidetoshi Kanazawa
Masato Nagino
Satoshi Kamiya
Shunichiro Komatsu
Toshihiko Mayumi
Kenji Takagi
Takashi Asahara
Koji Nomoto
Ryuichiro Tanaka
Yuji Nimura
Publikationsdatum
01.04.2005
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 2/2005
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-004-0536-1

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