The role of probiotics in gastrointestinal surgery.
OBJECTIVE
Postoperative complications in gastrointestinal elective surgery have been described as low. In certain circumstances, however, such as those including high-risk patients, the incidence is higher. In such situations, bacteremia and infectious complications may be caused by translocation of either gastrointestinal bacteria or its toxins as the result of bacterial overgrowth, loss of intestinal epithelial integrity, or immunologic compromising of the host. Attempts should be made to reduce the impact of these factors. Probiotics, which confer to the host health benefits similar to those offered by a balanced indigenous microbiota, are thought to act through a variety of mechanisms including the competition with potential pathogens for nutrients or enterocyte adhesion sites, degradation of toxins, production of antimicrobial factors, and local and systemic immunomodulation.


RESULTS
Recent studies have shown that probiotics play a role in decreasing postoperative complications in patients undergoing major gastrointestinal operations.


CONCLUSIONS
Considering the mechanisms of action of probiotics in the gastrointestinal tract, mainly in the intestine, evidence strongly suggests that the use of these microorganisms might positively affect the complication rate in patients undergoing surgery on the gastrointestinal tract.
Correia
M Isabel T D
MI
Department of Surgery, Federal University of Minas Gerais, Belo Horizonte, Brazil. isabel_correia@uol.com.br
Nicoli
Jacques R
JR
D018988:Bacterial Translocation; D041981:Gastrointestinal Tract / Q000601:surgery*; D006801:Humans; D007410:Intestinal Diseases / Q000517:prevention & control; D011183:Postoperative Complications / Q000517:prevention & control*; D019936:Probiotics