ORIGINAL SCIENTIFIC REPORT: A Four-Probiotics Regimen Reduces Postoperative Complications
After Colorectal Surgery: A Randomized, Double-Blind, Placebo-Controlled Study
"Most of postoperative infectious complications are linked with gut microbiota; it is proposed that modulation of the gut mi-crobiota with probiotics may prevent postoperative infec-tions [6,7]."
"Reduction of complications in the probiotics group involved significant reduction of the incidence of (a) postoperative infections mainly of lower lung infections and of surgical site infections, (b) of anastomotic leakage and (c) the need for postoperative intubation and mechanical ventilation."
"However, it should be underscored that the successful achievement of the study primary endpoint was shown at the premature stop of the study. More precisely, at the planned interim analysis after inclusion of 40 % of the calculated sample size, this significant difference for the
primary outcome was found and the study was stopped prematurely."
"The present randomized controlled study evidenced a considerable reduction of overall major complications and of infectious complications within the first 30 days after colorectal surgery with a combined probiotic formula of four probiotics ( L. acidophilus LA-5, L. plantarum, B.
lactis BB-12 and S. boulardii ) over placebo. The benefit did not involve only the reduction of the absolute com- plication rate but also shortening of the time until hospital discharge."
"Modern surgical fast tract protocol fully supports the avoidance of mechanical bowel cleansing and advice for laparoscopic intervention [ 17,18]; our department still in-sists on traditional surgical techniques; this is why the study design involved start of probiotics the day before
surgery, immediately after termination of bowel cleansing.Despite these old-fashioned attitudes, the benefit described in this study resembles the findings reported by Zhang et al."