Positive regulatory effects of perioperative probiotic treatment on postoperative liver complications after colorectal liver metastases surgery: a double-center and double-blind randomized clinical trial

BMC Gastroenterology

Jianping Wang¹  Liang Kang¹  Huanlong Qin²  Yanxing Luo¹  Xiaojian Wu¹  Junsheng Peng¹  Nanqi Huang¹  Peng Zhang²  Ping Lan¹  Hui Peng¹  Lei Wang¹  Xingwei Zhang¹  Chao Tong¹  Meijin Huang¹  Chao Li¹  Zhihua Liu² 

[1] Gastrointestinal Institute of Sun Yat-sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou 510655, Guangdong, People’s Republic of China;Department of Surgery, Shanghai JiaoTong University Affiliated Sixth People’s Hospital, Shanghai 200233, China

关键词: Liver barrier;    Postoperative complication;    Zonulin;    Colorectal liver metastases;    Probiotics;   

Others  :  1144748
DOI  :  10.1186/s12876-015-0260-z

 received in 2014-09-30, accepted in 2015-02-27,  发布年份 2015

【 摘 要 】

Background

Colorectal liver metastases (CLM) occur frequently and postoperative intestinal infection is a common complication. Our previous study showed that probiotics could decrease the rate of infectious complications after colectomy for colorectal cancer. To determine the effects of the perioperative administration of probiotics on serum zonulin levels which is a marker of intestinal permeability and the subsequent impact on postoperative infectious complications in patients with CLM.

Methods

150 patients with CLM were randomly divided into control group (n = 68) and probiotics group (n = 66). Probiotics and placebo were given orally for 6 days preoperatively and 10 days postoperatively to control group and probiotics group respectively. We used the local resection for metastatic tumor ,while for large tumor, the segmental hepatectomy. Postoperative outcome were recorded. Furthermore, complications in patients with normal intestinal barrier function and the relation with serum zonulin were analyzed to evaluate the impact on the liver barrier dysfunction.

Results

The incidence of infectious complications in the probiotics group was lower than control group. Analysis of CLM patients with normal postoperative intestinal barrier function paralleled with the serum zonulin level. And probiotics could also reduce the concentration of serum zonulin (P = 0.004) and plasma endotoxin (P < 0.001).

Conclusion

Perioperative probiotics treatment could reduce the serum zonulin level, the rate of postoperative septicemia and maintain the liver barrier in patients undergoing CLM surgery. we propose a new model about the regulation of probiotics to liver barrier via clinical regulatory pathway. We recommend the preoperative oral intake of probiotics combined with postoperative continued probiotics treatment in patients who undergo CLM surgery.

Trial registration

ChiCTR-TRC-12002841 webcite. 2012/12/21

【 授权许可】

   
2015 Liu et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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