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Erschienen in: Surgery Today 4/2016

01.04.2016 | Original Article

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

verfasst von: Shunichiro Komatsu, Eiji Sakamoto, Shinji Norimizu, Yuji Shingu, Takashi Asahara, Koji Nomoto, Masato Nagino

Erschienen in: Surgery Today | Ausgabe 4/2016

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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.
Literatur
1.
Zurück zum Zitat Clinical Outcomes of Surgical Therapy Study G. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9.CrossRef Clinical Outcomes of Surgical Therapy Study G. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350(20):2050–9.CrossRef
2.
Zurück zum Zitat Franks PJ, Bosanquet N, Thorpe H, Brown JM, Copeland J, Smith AM, et al. Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer. 2006;95(1):6–12.PubMedCentralCrossRefPubMed Franks PJ, Bosanquet N, Thorpe H, Brown JM, Copeland J, Smith AM, et al. Short-term costs of conventional vs laparoscopic assisted surgery in patients with colorectal cancer (MRC CLASICC trial). Br J Cancer. 2006;95(1):6–12.PubMedCentralCrossRefPubMed
3.
Zurück zum Zitat Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, et al. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet. 2004;363(9416):1187–92.CrossRefPubMed Leung KL, Kwok SP, Lam SC, Lee JF, Yiu RY, Ng SS, et al. Laparoscopic resection of rectosigmoid carcinoma: prospective randomised trial. Lancet. 2004;363(9416):1187–92.CrossRefPubMed
4.
Zurück zum Zitat Schwenk W, Haase O, Neudecker J, Muller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev. 2005;20(3):CD003145. Schwenk W, Haase O, Neudecker J, Muller JM. Short term benefits for laparoscopic colorectal resection. Cochrane Database Syst Rev. 2005;20(3):CD003145.
5.
Zurück zum Zitat Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.CrossRefPubMed Veldkamp R, Kuhry E, Hop WC, Jeekel J, Kazemier G, Bonjer HJ, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial. Lancet Oncol. 2005;6(7):477–84.CrossRefPubMed
6.
Zurück zum Zitat Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G, Clinical Outcomes of Surgical Therapy Study G. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA. 2002;287(3):321–8.CrossRefPubMed Weeks JC, Nelson H, Gelber S, Sargent D, Schroeder G, Clinical Outcomes of Surgical Therapy Study G. Short-term quality-of-life outcomes following laparoscopic-assisted colectomy vs open colectomy for colon cancer: a randomized trial. JAMA. 2002;287(3):321–8.CrossRefPubMed
7.
Zurück zum Zitat Colon Cancer Laparoscopic or Open Resection Study G, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10(1):44–52.CrossRefPubMed Colon Cancer Laparoscopic or Open Resection Study G, Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, et al. Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol. 2009;10(1):44–52.CrossRefPubMed
8.
Zurück zum Zitat Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr. Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg. 2007;204(3):439–46.CrossRefPubMed Jackson TD, Kaplan GG, Arena G, Page JH, Rogers SO Jr. Laparoscopic versus open resection for colorectal cancer: a metaanalysis of oncologic outcomes. J Am Coll Surg. 2007;204(3):439–46.CrossRefPubMed
9.
Zurück zum Zitat Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 2007;25(21):3061–8.CrossRefPubMed Jayne DG, Guillou PJ, Thorpe H, Quirke P, Copeland J, Smith AM, et al. Randomized trial of laparoscopic-assisted resection of colorectal carcinoma: 3-year results of the UK MRC CLASICC Trial Group. J Clin Oncol. 2007;25(21):3061–8.CrossRefPubMed
10.
Zurück zum Zitat Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–9.CrossRefPubMed Lacy AM, Garcia-Valdecasas JC, Delgado S, Castells A, Taura P, Pique JM, et al. Laparoscopy-assisted colectomy versus open colectomy for treatment of non-metastatic colon cancer: a randomised trial. Lancet. 2002;359(9325):2224–9.CrossRefPubMed
11.
Zurück zum Zitat Poon JT, Law WL, Wong IW, Ching PT, Wong LM, Fan JK, et al. Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg. 2009;249(1):77–81.CrossRefPubMed Poon JT, Law WL, Wong IW, Ching PT, Wong LM, Fan JK, et al. Impact of laparoscopic colorectal resection on surgical site infection. Ann Surg. 2009;249(1):77–81.CrossRefPubMed
12.
Zurück zum Zitat Drosdeck J, Harzman A, Suzo A, Arnold M, Abdel-Rasoul M, Husain S. Multivariate analysis of risk factors for surgical site infection after laparoscopic colorectal surgery. Surg Endosc. 2013;27(12):4574–80.CrossRefPubMed Drosdeck J, Harzman A, Suzo A, Arnold M, Abdel-Rasoul M, Husain S. Multivariate analysis of risk factors for surgical site infection after laparoscopic colorectal surgery. Surg Endosc. 2013;27(12):4574–80.CrossRefPubMed
13.
Zurück zum Zitat Itatsu K, Sugawara G, Kaneoka Y, Kato T, Takeuchi E, Kanai M, et al. Risk factors for incisional surgical site infections in elective surgery for colorectal cancer: focus on intraoperative meticulous wound management. Surg Today. 2014;44(7):1242–52.CrossRefPubMed Itatsu K, Sugawara G, Kaneoka Y, Kato T, Takeuchi E, Kanai M, et al. Risk factors for incisional surgical site infections in elective surgery for colorectal cancer: focus on intraoperative meticulous wound management. Surg Today. 2014;44(7):1242–52.CrossRefPubMed
14.
Zurück zum Zitat Konishi T, Watanabe T, Kishimoto J, Nagawa H. Elective colon and rectal surgery differ in risk factors for wound infection: results of prospective surveillance. Ann Surg. 2006;244(5):758–63.PubMedCentralCrossRefPubMed Konishi T, Watanabe T, Kishimoto J, Nagawa H. Elective colon and rectal surgery differ in risk factors for wound infection: results of prospective surveillance. Ann Surg. 2006;244(5):758–63.PubMedCentralCrossRefPubMed
15.
Zurück zum Zitat Romy S, Eisenring MC, Bettschart V, Petignat C, Francioli P, Troillet N. Laparoscope use and surgical site infections in digestive surgery. Ann Surg. 2008;247(4):627–32.CrossRefPubMed Romy S, Eisenring MC, Bettschart V, Petignat C, Francioli P, Troillet N. Laparoscope use and surgical site infections in digestive surgery. Ann Surg. 2008;247(4):627–32.CrossRefPubMed
16.
Zurück zum Zitat Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, et al. Wound infection after elective colorectal resection. Ann Surg. 2004;239(5):599–605 discussion-7.PubMedCentralCrossRefPubMed Smith RL, Bohl JK, McElearney ST, Friel CM, Barclay MM, Sawyer RG, et al. Wound infection after elective colorectal resection. Ann Surg. 2004;239(5):599–605 discussion-7.PubMedCentralCrossRefPubMed
17.
Zurück zum Zitat Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, et al. Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2809 consecutive patients. Ann Surg. 2001;234(2):181–9.PubMedCentralCrossRefPubMed Tang R, Chen HH, Wang YL, Changchien CR, Chen JS, Hsu KC, et al. Risk factors for surgical site infection after elective resection of the colon and rectum: a single-center prospective study of 2809 consecutive patients. Ann Surg. 2001;234(2):181–9.PubMedCentralCrossRefPubMed
18.
Zurück zum Zitat Collins MD, Gibson GR. Probiotics, prebiotics, and synbiotics: approaches for modulating the microbial ecology of the gut. Am J Clin Nutr. 1999;69(5):1052S–7S.PubMed Collins MD, Gibson GR. Probiotics, prebiotics, and synbiotics: approaches for modulating the microbial ecology of the gut. Am J Clin Nutr. 1999;69(5):1052S–7S.PubMed
19.
Zurück zum Zitat Kanazawa H, Nagino M, Kamiya S, Komatsu S, Mayumi T, Takagi K, et al. Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbecks Arch Surg. 2005;390(2):104–13.CrossRefPubMed Kanazawa H, Nagino M, Kamiya S, Komatsu S, Mayumi T, Takagi K, et al. Synbiotics reduce postoperative infectious complications: a randomized controlled trial in biliary cancer patients undergoing hepatectomy. Langenbecks Arch Surg. 2005;390(2):104–13.CrossRefPubMed
20.
Zurück zum Zitat Rayes N, Seehofer D, Theruvath T, Mogl M, Langrehr JM, Nussler NC, et al. Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial. Ann Surg. 2007;246(1):36–41.PubMedCentralCrossRefPubMed Rayes N, Seehofer D, Theruvath T, Mogl M, Langrehr JM, Nussler NC, et al. Effect of enteral nutrition and synbiotics on bacterial infection rates after pylorus-preserving pancreatoduodenectomy: a randomized, double-blind trial. Ann Surg. 2007;246(1):36–41.PubMedCentralCrossRefPubMed
21.
Zurück zum Zitat Rayes N, Seehofer D, Theruvath T, Schiller RA, Langrehr JM, Jonas S, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5(1):125–30.CrossRefPubMed Rayes N, Seehofer D, Theruvath T, Schiller RA, Langrehr JM, Jonas S, et al. Supply of pre- and probiotics reduces bacterial infection rates after liver transplantation—a randomized, double-blind trial. Am J Transplant. 2005;5(1):125–30.CrossRefPubMed
22.
Zurück zum Zitat Sugawara G, Nagino M, Nishio H, Ebata T, Takagi K, Asahara T, et al. Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: a randomized controlled trial. Ann Surg. 2006;244(5):706–14.PubMedCentralCrossRefPubMed Sugawara G, Nagino M, Nishio H, Ebata T, Takagi K, Asahara T, et al. Perioperative synbiotic treatment to prevent postoperative infectious complications in biliary cancer surgery: a randomized controlled trial. Ann Surg. 2006;244(5):706–14.PubMedCentralCrossRefPubMed
23.
Zurück zum Zitat Anderson AD, McNaught CE, Jain PK, MacFie J. Randomised clinical trial of synbiotic therapy in elective surgical patients. Gut. 2004;53(2):241–5.PubMedCentralCrossRefPubMed Anderson AD, McNaught CE, Jain PK, MacFie J. Randomised clinical trial of synbiotic therapy in elective surgical patients. Gut. 2004;53(2):241–5.PubMedCentralCrossRefPubMed
24.
Zurück zum Zitat McNaught CE, Woodcock NP, MacFie J, Mitchell CJ. A prospective randomised study of the probiotic Lactobacillus plantarum 299 V on indices of gut barrier function in elective surgical patients. Gut. 2002;51(6):827–31.PubMedCentralCrossRefPubMed McNaught CE, Woodcock NP, MacFie J, Mitchell CJ. A prospective randomised study of the probiotic Lactobacillus plantarum 299 V on indices of gut barrier function in elective surgical patients. Gut. 2002;51(6):827–31.PubMedCentralCrossRefPubMed
25.
Zurück zum Zitat Reddy BS, Macfie J, Gatt M, Larsen CN, Jensen SS, Leser TD. Randomized clinical trial of effect of synbiotics, neomycin and mechanical bowel preparation on intestinal barrier function in patients undergoing colectomy. Br J Surg. 2007;94(5):546–54.CrossRefPubMed Reddy BS, Macfie J, Gatt M, Larsen CN, Jensen SS, Leser TD. Randomized clinical trial of effect of synbiotics, neomycin and mechanical bowel preparation on intestinal barrier function in patients undergoing colectomy. Br J Surg. 2007;94(5):546–54.CrossRefPubMed
26.
Zurück zum Zitat Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005;307(5717):1915–20.CrossRefPubMed Backhed F, Ley RE, Sonnenburg JL, Peterson DA, Gordon JI. Host-bacterial mutualism in the human intestine. Science. 2005;307(5717):1915–20.CrossRefPubMed
27.
Zurück zum Zitat Cecil TD, Sexton R, Moran BJ, Heald RJ. Total mesorectal excision results in low local recurrence rates in lymph node-positive rectal cancer. Dis Colon Rectum. 2004;47(7):1145–9 discussion 9–50.CrossRefPubMed Cecil TD, Sexton R, Moran BJ, Heald RJ. Total mesorectal excision results in low local recurrence rates in lymph node-positive rectal cancer. Dis Colon Rectum. 2004;47(7):1145–9 discussion 9–50.CrossRefPubMed
28.
Zurück zum Zitat Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control. 1992;20(5):271–4.CrossRefPubMed Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Am J Infect Control. 1992;20(5):271–4.CrossRefPubMed
29.
Zurück zum Zitat Matsuda K, Tsuji H, Asahara T, Kado Y, Nomoto K. Sensitive quantitative detection of commensal bacteria by rRNA-targeted reverse transcription-PCR. Appl Environ Microbiol. 2007;73(1):32–9.PubMedCentralCrossRefPubMed Matsuda K, Tsuji H, Asahara T, Kado Y, Nomoto K. Sensitive quantitative detection of commensal bacteria by rRNA-targeted reverse transcription-PCR. Appl Environ Microbiol. 2007;73(1):32–9.PubMedCentralCrossRefPubMed
30.
Zurück zum Zitat Matsuda K, Tsuji H, Asahara T, Matsumoto K, Takada T, Nomoto K. Establishment of an analytical system for the human fecal microbiota, based on reverse transcription-quantitative PCR targeting of multicopy rRNA molecules. Appl Environ Microbiol. 2009;75(7):1961–9.PubMedCentralCrossRefPubMed Matsuda K, Tsuji H, Asahara T, Matsumoto K, Takada T, Nomoto K. Establishment of an analytical system for the human fecal microbiota, based on reverse transcription-quantitative PCR targeting of multicopy rRNA molecules. Appl Environ Microbiol. 2009;75(7):1961–9.PubMedCentralCrossRefPubMed
31.
Zurück zum Zitat Matsuda K, Tsuji H, Asahara T, Takahashi T, Kubota H, Nagata S, et al. Sensitive quantification of Clostridium difficile cells by reverse transcription-quantitative PCR targeting rRNA molecules. Appl Environ Microbiol. 2012;78(15):5111–8.PubMedCentralCrossRefPubMed Matsuda K, Tsuji H, Asahara T, Takahashi T, Kubota H, Nagata S, et al. Sensitive quantification of Clostridium difficile cells by reverse transcription-quantitative PCR targeting rRNA molecules. Appl Environ Microbiol. 2012;78(15):5111–8.PubMedCentralCrossRefPubMed
32.
Zurück zum Zitat Fujimoto J, Matsuki T, Sasamoto M, Tomii Y, Watanabe K. Identification and quantification of Lactobacillus casei strain Shirota in human feces with strain-specific primers derived from randomly amplified polymorphic DNA. Int J Food Microbiol. 2008;126(1–2):210–5.CrossRefPubMed Fujimoto J, Matsuki T, Sasamoto M, Tomii Y, Watanabe K. Identification and quantification of Lactobacillus casei strain Shirota in human feces with strain-specific primers derived from randomly amplified polymorphic DNA. Int J Food Microbiol. 2008;126(1–2):210–5.CrossRefPubMed
33.
Zurück zum Zitat Fujimoto J, Tanigawa K, Kudo Y, Makino H, Watanabe K. Identification and quantification of viable Bifidobacterium breve strain Yakult in human faeces by using strain-specific primers and propidium monoazide. J Appl Microbiol. 2011;110(1):209–17.CrossRefPubMed Fujimoto J, Tanigawa K, Kudo Y, Makino H, Watanabe K. Identification and quantification of viable Bifidobacterium breve strain Yakult in human faeces by using strain-specific primers and propidium monoazide. J Appl Microbiol. 2011;110(1):209–17.CrossRefPubMed
34.
Zurück zum Zitat Horvat M, Krebs B, Potrc S, Ivanecz A, Kompan L. Preoperative synbiotic bowel conditioning for elective colorectal surgery. Wien Klin Wochenschr. 2010;122(Suppl 2):26–30.CrossRefPubMed Horvat M, Krebs B, Potrc S, Ivanecz A, Kompan L. Preoperative synbiotic bowel conditioning for elective colorectal surgery. Wien Klin Wochenschr. 2010;122(Suppl 2):26–30.CrossRefPubMed
35.
Zurück zum Zitat Liu Z, Qin H, Yang Z, Xia Y, Liu W, Yang J, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery—a double-blind study. Aliment Pharmacol Ther. 2011;33(1):50–63.CrossRefPubMed Liu Z, Qin H, Yang Z, Xia Y, Liu W, Yang J, et al. Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery—a double-blind study. Aliment Pharmacol Ther. 2011;33(1):50–63.CrossRefPubMed
36.
Zurück zum Zitat Zhang JW, Du P, Gao J, Yang BR, Fang WJ, Ying CM. Preoperative probiotics decrease postoperative infectious complications of colorectal cancer. Am J Med Sci. 2012;343(3):199–205.CrossRefPubMed Zhang JW, Du P, Gao J, Yang BR, Fang WJ, Ying CM. Preoperative probiotics decrease postoperative infectious complications of colorectal cancer. Am J Med Sci. 2012;343(3):199–205.CrossRefPubMed
37.
Zurück zum Zitat He D, Wang HY, Feng JY, Zhang MM, Zhou Y, Wu XT. Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol. 2013;37(4):406–15.CrossRefPubMed He D, Wang HY, Feng JY, Zhang MM, Zhou Y, Wu XT. Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials. Clin Res Hepatol Gastroenterol. 2013;37(4):406–15.CrossRefPubMed
38.
Zurück zum Zitat Raman M, Ambalam P, Kondepudi KK, Pithva S, Kothari C, Patel AT, et al. Potential of probiotics, prebiotics and synbiotics for management of colorectal cancer. Gut Microbes. 2013;4(3):181–92.PubMedCentralCrossRefPubMed Raman M, Ambalam P, Kondepudi KK, Pithva S, Kothari C, Patel AT, et al. Potential of probiotics, prebiotics and synbiotics for management of colorectal cancer. Gut Microbes. 2013;4(3):181–92.PubMedCentralCrossRefPubMed
39.
Zurück zum Zitat Sadahiro S, Suzuki T, Tanaka A, Okada K, Kamata H, Ozaki T, et al. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: prospective randomized trial. Surgery. 2014;155(3):493–503.CrossRefPubMed Sadahiro S, Suzuki T, Tanaka A, Okada K, Kamata H, Ozaki T, et al. Comparison between oral antibiotics and probiotics as bowel preparation for elective colon cancer surgery to prevent infection: prospective randomized trial. Surgery. 2014;155(3):493–503.CrossRefPubMed
41.
Zurück zum Zitat Correia MI, Liboredo JC, Consoli ML. The role of probiotics in gastrointestinal surgery. Nutrition. 2012;28(3):230–4.CrossRefPubMed Correia MI, Liboredo JC, Consoli ML. The role of probiotics in gastrointestinal surgery. Nutrition. 2012;28(3):230–4.CrossRefPubMed
42.
Zurück zum Zitat Peitsidou K, Karantanos T, Theodoropoulos GE. Probiotics, prebiotics, synbiotics: is there enough evidence to support their use in colorectal cancer surgery? Dig Surg. 2012;29(5):426–38.CrossRefPubMed Peitsidou K, Karantanos T, Theodoropoulos GE. Probiotics, prebiotics, synbiotics: is there enough evidence to support their use in colorectal cancer surgery? Dig Surg. 2012;29(5):426–38.CrossRefPubMed
43.
Zurück zum Zitat Watanabe M, Murakami M, Nakao K, Asahara T, Nomoto K, Tsunoda A. Randomized clinical trial of the influence of mechanical bowel preparation on faecal microflora in patients undergoing colonic cancer resection. Br J Surg. 2010;97(12):1791–7.CrossRefPubMed Watanabe M, Murakami M, Nakao K, Asahara T, Nomoto K, Tsunoda A. Randomized clinical trial of the influence of mechanical bowel preparation on faecal microflora in patients undergoing colonic cancer resection. Br J Surg. 2010;97(12):1791–7.CrossRefPubMed
44.
Zurück zum Zitat Nishigaki E, Abe T, Yokoyama Y, Fukaya M, Asahara T, Nomoto K et al. The detection of intraoperative bacterial translocation in the mesenteric lymph nodes is useful in predicting patients at high risk for postoperative infectious complications after esophagectomy. Ann Surg. 2014;259(3):477–84.CrossRefPubMed Nishigaki E, Abe T, Yokoyama Y, Fukaya M, Asahara T, Nomoto K et al. The detection of intraoperative bacterial translocation in the mesenteric lymph nodes is useful in predicting patients at high risk for postoperative infectious complications after esophagectomy. Ann Surg. 2014;259(3):477–84.CrossRefPubMed
45.
Zurück zum Zitat Tanaka K, Yano M, Motoori M, Kishi K, Miyashiro I, Ohue M, et al. Impact of perioperative administration of synbiotics in patients with esophageal cancer undergoing esophagectomy: a prospective randomized controlled trial. Surgery. 2012;152(5):832–42.CrossRefPubMed Tanaka K, Yano M, Motoori M, Kishi K, Miyashiro I, Ohue M, et al. Impact of perioperative administration of synbiotics in patients with esophageal cancer undergoing esophagectomy: a prospective randomized controlled trial. Surgery. 2012;152(5):832–42.CrossRefPubMed
46.
Zurück zum Zitat Yokoyama Y, Nishigaki E, Abe T, Fukaya M, Asahara T, Nomoto K, et al. Randomized clinical trial of the effect of perioperative synbiotics versus no synbiotics on bacterial translocation after oesophagectomy. Br J Surg. 2014;101(3):189–99.CrossRefPubMed Yokoyama Y, Nishigaki E, Abe T, Fukaya M, Asahara T, Nomoto K, et al. Randomized clinical trial of the effect of perioperative synbiotics versus no synbiotics on bacterial translocation after oesophagectomy. Br J Surg. 2014;101(3):189–99.CrossRefPubMed
47.
Zurück zum Zitat Cannon JA, Altom LK, Deierhoi RJ, Morris M, Richman JS, Vick CC, et al. Preoperative oral antibiotics reduce surgical site infection following elective colorectal resections. Dis Colon Rectum. 2012;55(11):1160–6.CrossRefPubMed Cannon JA, Altom LK, Deierhoi RJ, Morris M, Richman JS, Vick CC, et al. Preoperative oral antibiotics reduce surgical site infection following elective colorectal resections. Dis Colon Rectum. 2012;55(11):1160–6.CrossRefPubMed
48.
Zurück zum Zitat Nelson RL, Gladman E, Barbateskovic M. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2014;5:CD001181.PubMed Nelson RL, Gladman E, Barbateskovic M. Antimicrobial prophylaxis for colorectal surgery. Cochrane Database Syst Rev. 2014;5:CD001181.PubMed
49.
Zurück zum Zitat Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431–55.CrossRefPubMed Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol. 2010;31(5):431–55.CrossRefPubMed
50.
Zurück zum Zitat Wren SM, Ahmed N, Jamal A, Safadi BY. Preoperative oral antibiotics in colorectal surgery increase the rate of Clostridium difficile colitis. Arch Surg. 2005;140(8):752–6.CrossRefPubMed Wren SM, Ahmed N, Jamal A, Safadi BY. Preoperative oral antibiotics in colorectal surgery increase the rate of Clostridium difficile colitis. Arch Surg. 2005;140(8):752–6.CrossRefPubMed
51.
Zurück zum Zitat Alp E, Elmali F, Ersoy S, Kucuk C, Doganay M. Incidence and risk factors of surgical site infection in general surgery in a developing country. Surg Today. 2014;44(4):685–9.CrossRefPubMed Alp E, Elmali F, Ersoy S, Kucuk C, Doganay M. Incidence and risk factors of surgical site infection in general surgery in a developing country. Surg Today. 2014;44(4):685–9.CrossRefPubMed
52.
Metadaten
Titel
Efficacy of perioperative synbiotics treatment for the prevention of surgical site infection after laparoscopic colorectal surgery: a randomized controlled trial
verfasst von
Shunichiro Komatsu
Eiji Sakamoto
Shinji Norimizu
Yuji Shingu
Takashi Asahara
Koji Nomoto
Masato Nagino
Publikationsdatum
01.04.2016
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 4/2016
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-015-1178-3

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