Preoperative Synbiotic Supplementation and Postoperative Outcomes in Elective GI Surgery: A Double-blinded, Placebo-controlled Trial

Abstract

Background: Surgery harms the gastrointestinal (GI) tract barrier and changes intestinal microbiota composition, disrupting the balance of gut flora. Synbiotics, which are mixtures of beneficial bacteria and chemicals that promote gut flora growth, are particularly important for recovery after GI surgery. We aimed to assess the effect of consumption of synbiotics prior to the gastrointestinal surgeries on complications. Materials and Methods: 40 patients who planned to undergo elective gastrointestinal surgery randomized in a double-blinded, placebo-controlled, phase 3 trial to a single dose perioperative and seven-day postoperative intervention with a synbiotic, LactoCare®, or placebo provided by knowledge-based spin-off company, Zist Takhmir. Randomisation was performed by a computer algorithm. Results: 42.5% of participants were men. Nausea and vomiting occurred in eight patients in the placebo group, and seven patients in the synbiotic group, and the two groups were not statistically significant (P>0.99). Other complications, such as (surgical site infection, fever, surgical site infection, pneumonia, and anastomosis site leakage) were not observed in the placebo or synbiotic groups. In assessing variables dependent on time, the mean time to start oral feeding in the synbiotic group was 32.35±28.84 hours after surgery, and in the placebo group was 28.45±24.91 hours (P=0.796). The first gas passing time was 13.00±15.81 hours in the synbiotic group and 9.65±13.90 hours in the placebo group after surgery(P=0.406). The hospitalisation length of patients in the synbiotic group was 2.6±1.27 days, and for patients in the placebo group was 2.35±1.08 days(P=0.42). Conclusion: Administration of synbiotics as a single dose before surgery and seven days postoperatively did not have a significant effect on infectious complications and time-dependent variables in patients with abdominal surgery.