title: Perioperative supplementation with bifidobacteria improves postoperative nutritional recovery, inflammatory response, and fecal microbiota in patients undergoing colorectal surgery: a prospective, randomized clinical trial.
abstract: The use of probiotics has been widely documented to benefit human health, but their clinical value in surgical patients remains unclear. The present study investigated the effect of perioperative oral administration of probiotic bifidobacteria to patients undergoing colorectal surgery. Sixty patients undergoing colorectal resection were randomized to two groups prior to resection. One group (n=31) received a probiotic supplement, Bifidobacterium longum BB536, preoperatively for 7-14 days and postoperatively for 14 days, while the other group (n=29) received no intervention as a control. The occurrences of postoperative infectious complications were recorded. Blood and fecal samples were collected before and after surgery. No significant difference was found in the incidence of postoperative infectious complications and duration of hospital stay between the two groups. In comparison to the control group, the probiotic group tended to have higher postoperative levels of erythrocytes, hemoglobin, lymphocytes, total protein, and albumin and lower levels of high sensitive C-reactive proteins. Postoperatively, the proportions of fecal bacteria changed significantly; Actinobacteria increased in the probiotic group, Bacteroidetes and Proteobacteria increased in the control group, and Firmicutes decreased in both groups. Significant correlations were found between the proportions of fecal bacteria and blood parameters; Actinobacteria correlated negatively with blood inflammatory parameters, while Bacteroidetes and Proteobacteria correlated positively with blood inflammatory parameters. In the subgroup of patients who received preoperative chemoradiotherapy treatment, the duration of hospital stay was significantly shortened upon probiotic intervention. These results suggest that perioperative oral administration of bifidobacteria may contribute to a balanced intestinal microbiota and attenuated postoperative inflammatory responses, which may subsequently promote a healthy recovery after colorectal resection.
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Mizuta
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Izuru
authors.initials: I
authors.lastname: Endo
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Sumiharu
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Inokawa
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Kubo
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Tetsunobu
authors.initials: T
authors.lastname: Udaka
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Osanori
authors.initials: O
authors.lastname: Sogabe
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Maeda
authors.affiliation: Mitoyo General Hospital, Takamatsu, Kagawa 769-1695, Japan.
authors.forename: Kazutoyo
authors.initials: K
authors.lastname: Shirakawa
authors.affiliation: Clinico Co., Ltd., Tokyo 153-0063, Japan.
authors.forename: Eriko
authors.initials: E
authors.lastname: Okazaki
authors.affiliation: Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan.
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Odamaki
authors.affiliation: Food Ingredients and Technology Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan.
authors.forename: Fumiaki
authors.initials: F
authors.lastname: Abe
authors.affiliation: Next Generation Science Institute, Morinaga Milk Industry Co., Ltd., 5-1-83 Higashihara, Zama City, Kanagawa 252-8583, Japan.
authors.forename: Jin-Zhong
authors.initials: JZ
authors.lastname: Xiao
keywords: Bifidobacterium; colorectal surgery; inflammation; microbiota; nutrition; postoperative complications; probiotics