title: Effect of Perioperative Synbiotic Treatment on Bacterial Translocation and Postoperative Infectious Complications after Pancreatoduodenectomy.
abstract: OBJECTIVE
  This study investigated the effect of perioperative synbiotics on bacterial translocation to mesenteric lymph nodes (MLNs) and occurrence of infectious complications following pancreatoduodenectomy (PD; University Hospital Medical Information Network ID 000003705).
  
  
  METHODS
  Patients who were scheduled to undergo PD were randomized to receive preoperative synbiotics or no synbiotics (control group). MLNs were harvested at laparotomy (MLN-1) and after the resection (MLN-2). Blood samples were collected before laparotomy (Blood-1) and on postoperative day 1 (Blood-2). Microorganisms in each sample were detected using a bacterium-specific ribosomal RNA-targeted reverse transcriptase-quantitative polymerase chain reaction.
  
  
  RESULTS
  Forty-four patients were included. In all samples, the bacterial detection rate in the MLN-1, MLN-2, Blood-1, and Blood-2 was lower in the synbiotics group than in the control group, although it did not reach a statistically significant difference. There was a significant correlation between the positivity of bacteria in the MLN-2 and Blood-2 samples (p = 0.009). The incidence rate of overall infectious complications was not significantly different between the 2 groups. Among various perioperative factors, the incidence of pancreatic fistula was the only factor that had a significant association with the incidence of infectious complications.
  
  
  CONCLUSIONS
  The preoperative use of synbiotics did not affect the incidence of infectious complications following PD.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Miyake
authors.forename: Toshio
authors.initials: T
authors.lastname: Kokuryo
authors.forename: Takashi
authors.initials: T
authors.lastname: Asahara
authors.forename: Koji
authors.initials: K
authors.lastname: Nomoto
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D018988:Bacterial Translocation; D005260:Female; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000382:microbiology* / Q000601:surgery; D008297:Male; D008643:Mesentery; D008875:Middle Aged; D010185:Pancreatic Fistula / Q000209:etiology*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects* / Q000379:methods; D019990:Perioperative Care; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D058616:Synbiotics