Zlepšuje aplikace probiotik klinické výsledky v kolorektální chirurgii?

Abstract

Aim: To evaluate the effects of pre-operative administration of type-specific probiotics in colorectal surgery on the rate of post-operative (especially infection-related) complications; on the period of antibiotic administration; and on the speed of restoration of gut motility and length of hospital stay. Methods: Patients undergoing elective colon or rectal resection with anastomosis from June 2011 to April 2013 were in turns randomly divided into the probiotics group (22 patients) and the control group (23 patients). Patients with probiotics received (twice daily, 10 days before surgery) enterosolvent capsules consisting of 6 × 109 of five different freeze-dried Lactobacilli and Bifidobacteria species (L. rhamnosus 55%, B. breve 20%, L. casei 15%, L. acidophilus 5%, B. longum 5%). Postoperatively, the inflammatory complications, duration of antibiotic treatment, speed of restoration of intestinal peristalsis in patients and length of hospital stay were evaluated. Results: The interval to first peristalsis was significantly shorter in the probiotics group compared with the control group (1.5 days vs 2.0 days; p = 0.01). The decrease in infection-related complications (surgical wound infection, pneumonia) in the probiotics group was not statistically significant. The shorter antibiotic administration period in the probiotics group was statistically significant at the significance level p = 0.089. The length of hospital stay in patients with probiotics was shorter than in the control group, but not significantly. An improvement of health in the probiotics patients occurred in 21 of 25 clinical and laboratory numerically assessed parameters (p = 0.01). Conclusion: Pre-operative probiotic administration (L. rhamnosus, B. breve, L. casei, L. acidophilus, B. longum) in patients undergoing colorectal resection with anastomosis resulted in faster restoration of intestinal peristalsis, and in an improved clinical state of the patients (especially reduced infection-related complications) described by 25 clinical and laboratory parameters.