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

Research Article

Huanlong Qin¹  Peng Zhang¹  Jianping Wang²  Liang Kang²  Junsheng Peng²  Ping Lan²  Hui Peng²  Yanxing Luo²  Chao Li²  Meijin Huang²  Chao Tong²  Xiaojian Wu²  Xingwei Zhang²  Nanqi Huang²  Lei Wang²  Zhihua Liu³ 

[1] Department of Surgery, Shanghai JiaoTong University Affiliated Sixth People’s Hospital, 200233, Shanghai, China;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, 510655, Guangzhou, Guangdong, People’s Republic of China;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, 510655, Guangzhou, Guangdong, People’s Republic of China;Department of Surgery, Shanghai JiaoTong University Affiliated Sixth People’s Hospital, 200233, Shanghai, China;

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

DOI  :  10.1186/s12876-015-0260-z

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

来源: Springer

【 摘 要 】

BackgroundColorectal 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.Methods150 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.ResultsThe 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).ConclusionPerioperative 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 registrationChiCTR-TRC-12002841. 2012/12/21

【 授权许可】

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© Liu et al.; licensee BioMed Central. 2015