术前使用合生制剂或对大肠癌患者有益
  • 一项前瞻性、随机、双盲、安慰剂对照研究中,73例结直肠癌患者随机分为两组,术前连续7天每天两次服用合生制剂(Simbioflora ®)或安慰剂(麦芽糖糊精);
  • 服用合生制剂显著降低了患者的IL-6和C反应蛋白等炎症指标,安慰剂无此作用;
  • 合生制剂组的术后30天内感染性并发症发生率(2.8%)、平均抗生素使用时间(1.42±0.5天)、平均住院时间(3.0±1.0天)和死亡事件(0起)显著少于安慰剂组(18.9%,3.74±4.3天,4.0±18天,3起)。
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mildbreeze
一项来自巴西的随机双盲对照试验表明,手术前连续7天服用合生制剂Simbioflora ®,显著改善了患者的炎症指标,减少了术后感染性并发症、抗生素使用时间和住院时间。该研究于近期在Nutrition发表,值得专业人士关注。
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Nutrition [IF:3.639]

Impact of the preoperative use of synbiotics in colorectal cancer patients: a prospective, randomized, double-blind, placebo-controlled study

结直肠癌患者在术前使用合生制剂的影响:一项前瞻性、随机、双盲、安慰剂对照研究

10.1016/j.nut.2018.06.004

2018-07-11, Article

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Background and Objective: The gastrointestinal microflora is involved in the development and regulation of the immune response. Non-pathogenic bacteria are important to prevent the development and subsequent invasion of enteropathogenic bacteria. Surgical trauma and intestinal preparation can disrupt the intestinal microbiota balance. Modulating the microbiota in the preoperative period in patients with colorectal cancer may have an impact in the occurrence of postoperative complications. The objective of this study is to assess the impact of preoperative synbiotic administration in patients with colorectal cancer subjected to colorectal resection.
Methods: A prospective, randomized, double-blind, placebo-controlled study of 73 colorectal cancer patients. Eight days before surgery, patients were randomized to receive either synbiotics (Simbioflora®) or placebo (maltodextrin). The envelopes were identical and labeled A or B. All patients underwent nutritional assessment, measurements of C-reactive protein (CRP), interleukin-6 (IL-6), serum albumin and transferrin. Patients were given a diluted envelope in 100 ml of water twice daily for 7 days. The occurrence of infectious or non-infectious complications, time of antibiotic use, duration of hospitalization and occurrence of deaths were recorded for 30 days postoperatively.
Results: Mean age, demographic data and tumor staging were similar between the groups at baseline. After 7 days of synbiotic intake there were significant reductions in IL-6 levels (163.2 ± 19.5 vs. 138.8 ± 12.5, p <0.001) and CRP (10.0 ± 5.2 vs 7.17 ± 3.2, p <0.001), whereas the control group did not present significant changes (IL-6: 154.2 ± 18.3 vs. 160.9 ± 18.6, NS and CRP:10.6 ± 6.18 vs 10.4 ± 6.1, NS). Serum albumin and transferrin did not show significant changes. Postoperative infectious complications occurred in 2.8% of patients in the synbiotic group and in 18,9% in the control group (p=0.02). The mean antibiotic usage time was 1.42 ± 0.5 days in the synbiotic group and 3.74 ± 4.3 days in the control group (p <0.001). The mean length of hospital stay was 3.0 ± 1.0 days in the synbiotic group and 4.0 ± 18 in the control group (p <0.001). There were 3 deaths in the control group and no mortality in the synbiotic group (p = 0.115).
Conclusions: The use of synbiotics for 7 days preoperatively in patients with colorectal cancer attenuates the inflammatory state and is associated with reduced morbidity, length of hospital stay and use of antibiotics.

First Authors:
Camila Brandão Polakowski

Correspondence Authors:
Camila Brandão Polakowski

All Authors:
Camila Brandão Polakowski,Massakazu Kato,Vinicius Basso Preti,Maria Eliana Madalozzo Schieferdecker,Antonio Carlos Ligocki Campos

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