Primjena sinbiotika u prijeoperacijskoj pripremi bolesnika za elektivnu operaciju debeloga crijeva [Synbiotics application in the preoperative preparation of patients for elective colorectal cancer surgery]

Krebs, Bojan (2014) Primjena sinbiotika u prijeoperacijskoj pripremi bolesnika za elektivnu operaciju debeloga crijeva [Synbiotics application in the preoperative preparation of patients for elective colorectal cancer surgery]. PhD thesis, Sveučilište u Zagrebu.

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Abstract

AIM: The aim of our study was to demonstrate higher concentration of lactic acid bacteria (LAB) at the colonic mucosa in patients treated with oral intake of synbiotics. We also tried to prove that the systemic inflammatory response after surgery is less severe in patients who either took synbiotics or prebiotics and that these patients have less postoperative complications and a favorable postoperative course. ----- METHODS: 73 patients with preceding colorectal operations were recruited. They were randomized into three groups. One group received preoperatively prebiotics, the second synbiotics in and third was preoperatively cleansed. We have defined the number of four different probiotic bacteria on colonic mucosa with polymerase chain reaction(PCR). Serum levels of interleukin-6, CRP, fibrinogen, white cell count and differential blood count were measured pre- and postoperatively to determine systemic inflammatory response. ----- RESULTS: We found out that in the synbiotic group there were considerably more LAB presented on the mucosa. They did pass the upper gastrointestinal tract and were isolated in colonic mucosa. On the other hand, we did not find any statistical differences in systemic inflammatory response measured by upper factors and no differences in postoperative course and complications rate between all three groups. ----- CONCLUSIONS: LAB used in our study reach the large bowel mucosa after oral intake but in our case that didn’t seem to have an effect on postoperative course following colorectal surgery for cancer.

Abstract in Croatian

CILJEVI: Cilj našeg istraživanja bio je dokazati da bolesnici s rakom debelog crijeva, koji su preoperativno dobivali sinbiotik ili prebiotik, imaju veću koncentraciju laktobacila na sluznici debelog crijeva. Također smo pokušali dokazati da je sustavni upalni odgovor, nakon operacije, manji u bolesnika koji su uzimal sinbiotik ili prebiotik i da ovi bolesnici imaju manje postoperativnih komplikacija i povoljniji postoperativni tijek. ----- METODE: U istraživanje je uključeno 73 bolesnika predviđenih za operativni zahvat na debelom crijevu. Bolesnici su podijeljeni u tri skupine. Jedna skupina dobila je prije operacije prebiotik, druga sinbiotik, a treća je bila preoperativno čiščena. Lančanom reakcijom polimeraze(PCR) pokušali smo dokazati prisutnost četiri različite probiotičke bakterije, prisutne u apliciranom sinbiotiku, na sluznici kolona. Prije i nakon operativnog zahvata, pomoću serijskih mjerenja serumske razine interleukina-6, CRP-a, fibrinogena, leukocita i diferencijalne krvne slike, mjerili smo sustavni upalni odgovor. Postoperativno smo pratili četiri različita klinička čimbenika: prvu peristaltika, prvi unos tvrde hrane, prvo pražnjenje plinova i prvi prolazak stolice. ----- REZULTATI: U grupi bolesnika, koja je dobivala sinbiotik, na sluznici debelog crijeva smo dokazali statistički značajno više laktobacila nego u ostale dvije grupe. S druge strane, nismo pronašli nikakve statističke razlike u sustavnom upalnom odgovoru. Također nije bilo razlike u postoperativnom tijeku i broju komplikacija između sve tri skupine. ----- ZAKLJUČAK: Nakon peroralnog unosa Synbiotica 2000Forte, koji sadrži četiri LAB, ti laktobacili se nalaze na sluznici debelog crijeva. Istraživanje također pokazuje da primjena sinbiotika i prebiotika tri dana prije operacije nema utjecaja na sustavni upalni odgovor, procijenjen ponavljanim mjerenjima IL-6, CRP, diferencijalnom krvnom slikom i fibrinogenom te nema učinka na postoperativni tijek.

Item Type: Thesis (PhD)
Mentors:
Mentor
Krznarić, Željko
Departments: Izvan medicinskog fakulteta
Depositing User: Marijan Šember
University: Sveučilište u Zagrebu
Institution: Medicinski fakultet
Number of Pages: 65
Status: Unpublished
Creators:
CreatorsEmail
Krebs, BojanUNSPECIFIED
Date: 23 April 2014
Date Deposited: 20 May 2014 11:39
Last Modified: 20 May 2014 11:39
Subjects: /
Related URLs:
    URI: http://medlib.mef.hr/id/eprint/2104

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