Yang Xia1, Zhe Yang, Hong-qi Chen, Huan-long Qin. 1. Department of Surgery, The 6th People Hospital of Shanghai, Shanghai Jiaotong University, Shanghai 200233, China.
Abstract
OBJECTIVE: To study the effect of bowel preparation with probiotics on intestinal barrier function after surgery for colorectal cancer. METHODS: A total of 60 patients undergone colonic surgery were randomly divided into two groups:the trial group and the control group. One-day bowel preparation with probiotics was administered in trial group, while 3-day conventional bowel preparation in control group. Quality of the preparation was estimated during operation and the structure of intestinal epithelium in the colon was observed by microscope. Levels of transmembrane binding protein(occludin) and IgA in the colon were detected by immunohistochemistry method. White blood cell counts, microbial DNA, and C-reactive protein were measured before surgery and 1, 7 days after surgery. Postoperative systemic inflammation response syndrome(SIRS) and infection were evaluated. RESULTS:Good and excellent bowel preparation were achieved in 88% in the trial group and 92% in the control group(P=0.072). The expression levels of occludin and IgA of colon were significantly higher in the trial group[(19.32 + or - 2.40)% and (7.60 + or - 1.48)%, respectively] compared with those of the control group [(16.21 + or - 2.54)% and (5.29 + or - 1.57)%,respectively]. The number of microbial DNA PCR-positive patients in the trial group was significantly less than that in the control group after operation. There were no significant differences in the rates of SIRS or complications between the two groups. CONCLUSION: One-day bowel preparation with probiotics can maintain the intestinal barrier function after surgery of colorectal cancer,which is suitable for elective colorectal surgery.
RCT Entities:
OBJECTIVE: To study the effect of bowel preparation with probiotics on intestinal barrier function after surgery for colorectal cancer. METHODS: A total of 60 patients undergone colonic surgery were randomly divided into two groups:the trial group and the control group. One-day bowel preparation with probiotics was administered in trial group, while 3-day conventional bowel preparation in control group. Quality of the preparation was estimated during operation and the structure of intestinal epithelium in the colon was observed by microscope. Levels of transmembrane binding protein(occludin) and IgA in the colon were detected by immunohistochemistry method. White blood cell counts, microbial DNA, and C-reactive protein were measured before surgery and 1, 7 days after surgery. Postoperative systemic inflammation response syndrome(SIRS) and infection were evaluated. RESULTS: Good and excellent bowel preparation were achieved in 88% in the trial group and 92% in the control group(P=0.072). The expression levels of occludin and IgA of colon were significantly higher in the trial group[(19.32 + or - 2.40)% and (7.60 + or - 1.48)%, respectively] compared with those of the control group [(16.21 + or - 2.54)% and (5.29 + or - 1.57)%,respectively]. The number of microbial DNA PCR-positive patients in the trial group was significantly less than that in the control group after operation. There were no significant differences in the rates of SIRS or complications between the two groups. CONCLUSION: One-day bowel preparation with probiotics can maintain the intestinal barrier function after surgery of colorectal cancer,which is suitable for elective colorectal surgery.