title: Early postoperative administration of probiotics versus placebo in elderly patients undergoing elective colorectal surgery: a double-blind randomized controlled trial.
abstract: BACKGROUND
  Perioperative prophylactic antibiotic treatment significantly influences intestinal microflora, resulting in impaired bowel functioning in some patients, sometimes requiring further investigations. This may lead to a worse health-related quality of life (HRQoL). Probiotics administrated in the early post-operative period may help avoiding such nuisances in older people.
  
  
  METHODS
  We prospectively enrolled patients undergoing laparoscopic colorectal surgery aged over 70 years between 2005 and 2012. The study was approved by IRB. All patients received perioperative antibiotic treatment. Patients were randomized to one of two treatment arms: Group A patients received probiotics after surgery (VSL#3, VSL Pharmaceuticals, Inc. USA - 900 × 109 daily, while Group B patients received a Placebo (cornstarch). Patients were further divided in sub-groups whether ileo-caecal valve was spared or not. Patients were followed-up every 7 days for 4 weeks. Patients daily annotated bowel frequency, stool shape and consistency - according to Bristol's scale. HRQoL was assessed every week by means of SF-36 questionnaire.
  
  
  RESULTS
  Group A included 10 while Group B included 8 patients. One patient in each group experienced a postoperative complication. Group A patients had fewer bowel movements than controls, during every week. Stool consistency was higher in patients undergoing resections including ileo-caecal valve receiving VSL#3. HRQoL gradually increased in both groups; Group A patients had higher "social functioning" item scores at week 1 and 4 than controls.
  
  
  CONCLUSIONS
  Elderly patients undergoing resection of ileo-caecal valve may benefit from an early probiotics administration pathway after perioperative antibiotic treatment.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pellino
authors.forename: Guido
authors.initials: G
authors.lastname: Sciaudone
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Candilio
authors.forename: Antonio
authors.initials: A
authors.lastname: Camerlingo
authors.forename: Rosa
authors.initials: R
authors.lastname: Marcellinaro
authors.forename: Serena
authors.initials: S
authors.lastname: De Fatico
authors.forename: Federica
authors.initials: F
authors.lastname: Rocco
authors.forename: Silvestro
authors.initials: S
authors.lastname: Canonico
authors.forename: Gabriele
authors.initials: G
authors.lastname: Riegler
authors.forename: Francesco
authors.initials: F
authors.lastname: Selvaggi
mesh_terms: D000368:Aged; D003108:Colonic Diseases / Q000601:surgery*; D013505:Digestive System Surgical Procedures; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D019936:Probiotics / Q000627:therapeutic use*; D011446:Prospective Studies; D012002:Rectal Diseases / Q000601:surgery*; D013997:Time Factors