29 oktober 2006: Bron: Ann Surg. 2006 Nov;244(5):706-714.

Wanneer patienten met operabele primaire leverkanker vooraf voedsel synbiotica (= mix van verschillende soorten probiotica) krijgen dan lopen zij significant minder risico op het krijgen van ernstige ontstekingen gerelateerd aan de operatie. Ook alle immuunmarkers gaven een significant positiever beeld bij de patienten in de groep van de synbiotica dan in de groep zonder. Dit is het resutlaat van een gerandomiseerde studie bij 100 patienten met primaire operabele leverkanker.

Perioperative Synbiotic Treatment to Prevent Postoperative Infectious Complications in Biliary Cancer Surgery: A Randomized Controlled Trial.
Sugawara G, Nagino M, Nishio H, Ebata T, Takagi K, Asahara T, Nomoto K, Nimura Y.
From the *Division of Surgical Oncology, Department of Surgery; Nagoya University Graduate School of Medicine, Nagoya, Japan; daggerNagoya University College of Medical Technology, Nagoya, Japan; and double daggerYakult Central Institute for Microbiological Research, Tokyo, Japan.

SUMMARY BACKGROUND DATA:: Use of synbiotics has been reported to benefit human health, but clinical value in surgical patients remains unclear.

OBJECTIVE:: To investigate the effect of perioperative oral administration of synbiotics upon intestinal barrier function, immune responses, systemic inflammatory responses, microflora, and surgical outcome in patients undergoing high-risk hepatobiliary resection.

METHODS:: Patients with biliary cancer involving the hepatic hilus (n = 101) were randomized before hepatectomy, into a group receiving postoperative enteral feeding with synbiotics (group A); or another receiving preoperative plus postoperative synbiotics (group B). Lactulose-mannitol (L/M) ratio, serum diamine oxidase (DAO) activity, natural killer (NK) cell activity, interleukin-6 (IL-6), fecal microflora, and fecal organic acid concentrations were determined before and after hepatectomy. Postoperative infectious complications were recorded.

RESULTS:: Of 101 patients, 81 completed the trial. Preoperative and postoperative changes in L/M ratio and DAO activity were similar between groups. Preoperatively in group B, NK activity, and lymphocyte counts increased, while IL-6 decreased significantly (P < 0.05). Postoperative serum IL-6, white blood cell counts, and C-reactive protein in group B were significantly lower than in group A (P < 0.05). During the preoperative period, numbers of Bifidobacterium colonies cultured from and total organic acid concentrations measured in feces increased significantly in group B (P < 0.05). Postoperative concentrations of total organic acids and acetic acid in feces were significantly higher in group B than in group A (P < 0.05). Incidence of postoperative infectious complications was 30.0% (12 of 40) in group A and 12.1% (5 of 41) in group B (P < 0.05).

CONCLUSIONS:: Preoperative oral administration of synbiotics can enhance immune responses, attenuate systemic postoperative inflammatory responses, and improve intestinal microbial environment. These beneficial effects likely reduce postoperative infectious complications after hepatobiliary resection for biliary tract cancer.

PMID: 17060763 [PubMed - as supplied by publisher]

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