title: Randomised clinical trial: the effects of perioperative probiotic treatment on barrier function and post-operative infectious complications in colorectal cancer surgery - a double-blind study.
abstract: BACKGROUND
  Infection following abdominal operation remains a major factor affecting the morbidity of patients after surgery.
  
  
  OBJECTIVE
  To determine the effects of perioperative administration of probiotics on the gut barrier function and the surgical outcome in patients undergoing elective colorectal surgery.
  
  
  METHODS
  One hundred patients with colorectal carcinoma were randomly divided into the control group (n = 50) and the probiotics group (n = 50). The probiotics were given orally for 6 days preoperatively and 10 days post-operatively. Outcomes were measured by bacterial translocation, gut permeability, the effect on the faecal microbiota, and the clinical outcomes such as infectious-related complications and gut defecation function.
  
  
  RESULTS
  Compared with the control group, probiotics group had increased transepithelial resistance (P < 0.05), reduced transmucosal permeation of horseradish peroxidase and lactulose/mannitol ratio, reduced bacterial translocation (P < 0.05), decreased ileal-bile acid binding protein (P < 0.05) and positive rate of blood bacterial DNA (P < 0.05) and an enhanced mucosal tight junction protein expression. They had decreased blood enteropathogenic bacteria and increased faecal bacterial variety. The post-operative recovery of peristalsis, incidence of diarrhoea, and infectious-related complications were also improved.
  
  
  CONCLUSIONS
  Probiotics can improve the integrity of gut mucosal barrier by benefiting the faecal microbiota, and decreasing infectious complications in patients with colorectal cancer undergoing colorectomy.
authors.affiliation: Department of Surgery, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, China.
authors.forename: Z
authors.initials: Z
authors.lastname: Liu
authors.forename: H
authors.initials: H
authors.lastname: Qin
authors.forename: Z
authors.initials: Z
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Xia
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.forename: J
authors.initials: J
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Jiang
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.forename: Z
authors.initials: Z
authors.lastname: Yang
authors.forename: Y
authors.initials: Y
authors.lastname: Wang
authors.forename: Q
authors.initials: Q
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000517:prevention & control*; D015179:Colorectal Neoplasms / Q000150:complications* / Q000601:surgery; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019990:Perioperative Care / Q000379:methods; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control; D019936:Probiotics / Q000494:pharmacology / Q000627:therapeutic use*; D011446:Prospective Studies; D016896:Treatment Outcome