Authors: Daniel Seehofer, M.D.,*,1 Nada Rayes, M.D.,* Reinhard Schiller, M.D.,† Martin Stockmann, M.D.,* Andrea R. Mu¨ller, Ph.D.,* Anja Schirmeier,* Frank Schaeper, M.D.,‡ Stefan G. Tullius, Ph.D.,* Stig Bengmark, Ph.D.,§ and Peter Neuhaus, Ph.D.*
Published: Journal of Surgical Research 117, 262–271 (2004).
The study was conducted in vivo on animals.
Design: An experimental design on rats using a control group (no synbiotics) and a treatment group receiving synbiotics.
Treatment: The rats were divided into seven groups: five of the groups received standard rat chow and were subjected to either sham-operation, 70% liver resection, colonic anastomosis, or a combination of 30 or 70% liver resection with synchronous colonic anastomosis, respectively. In two additional groups with synchronous operation, a combination of four different lactic acid bacteria and four fibers was administered two times daily pre- and postoperatively. (A combination of four different probiotic strains and four different fibers was used for the experiments: Rats in the treatment groups each received 109 Pediacoccus pentoseceus 5-33:3, Lactococcus raffinolactis 32-77:1, Lactobacillus paracasei subspecies paracasei 19, and Lactobacillus plantarum 2362, as well as 0.2 g betaglukan, inulin, pectin, and resistant starch). Synbiotics were administered orally for a defined period before and after inducing conditions known to promote bacterial translocation.
Where and when: Germany
Sample size: 68 rats.
Sample criteria: Male Sprague Dawley rats weighing 250–350 g were used for all experiments.
Analysed material: Bacterial concentrations in cecum, mesenteric lymph nodes, liver, and spleen were analyzed and blood cultures were taken 48 h after operation. Furthermore, the following parameters were assessed: histological changes in the intestine, intestinal paracellular permeability (Ussing chamber), bursting pressure of the colonic anastomosis, and mitosis rate of the remnant liver.
Results
Application of probiotics significantly decreased bacterial concentration in the lymph nodes. In addition, animals with a high cecal concentration of lactobacilli had less translocation than the others. (s. 262).
Indicative results
Synchronous liver resection and colon anastomosis led to increased bacterial translocation compared to the single operations in the rat model. It is possible to diminish this process by oral administration of probiotics. (s. 262).
Synbiotic treatment was associated with lower levels of inflammatory markers, suggesting a protective effect against systemic inflammation caused by bacterial translocation.
Death of cells in the liver and inflammatory infiltrates in the liver has been prevented by administration of probiotics. Even prebiotics alone could reduce bacterial translocation to mesenteric lymph nodes and blood after 70 and 90% liver resection in rats. Up till this study, no data were available on combined administration of pre- and probiotics. (s. 268).
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