Randomized Controlled Trial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2024; 16(5): 1371-1376
Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1371
Effects of oral probiotics on inflammation and intestinal function in adult patients after appendectomy: Randomized controlled trial
Ke Lan, Ke-Rui Zeng, Fu-Rui Zhong, Sheng-Jin Tu, Jin-Long Luo, Shi-Long Shu, Xue-Feng Peng, Hua Yang, Kai Lu
Ke Lan, Ke-Rui Zeng, Fu-Rui Zhong, Sheng-Jin Tu, Jin-Long Luo, Shi-Long Shu, Xue-Feng Peng, Hua Yang, Kai Lu, Department of General Surgery, Zigong Fourth People's Hospital, Zigong 643000, Sichuan Province, China
Author contributions: Lan K designed this study; Lan K, Zeng KR, Zhong FR, Tu SJ and Luo JL collected and analyzed the data; Lan K drafted the manuscript and Lu K gave final approval of the version to be published; Shu SL, Peng XF and Yang H took part in this study as endoscopic operators or assistants.
Institutional review board statement: This study was approved by the Ethics Committee of Zigong Fourth People's Hospital and adhered to the ethical guidelines laid down by them (Approval No. 2023012).
Clinical trial registration statement: This study has already undergone retrospective registration for the clinical trial at https://www.chictr.org.cn/. The registration identification number is ChiCTR2400083131.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at 597768288@qq.com.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: Https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Lu, MD, Doctor, Surgeon, Surgical Oncologist, Department of General Surgery, Zigong Fourth People's Hospital, No. 400 Dangui Street, Ziliujing District, Zigong 643000, Sichuan Province, China. 597768288@qq.com
Received: December 20, 2023
Revised: February 28, 2024
Accepted: April 17, 2024
Published online: May 27, 2024
Processing time: 155 Days and 8 Hours
Abstract
BACKGROUND

Appendectomy is an acute abdominal surgery that is often accompanied by severe abdominal inflammation. Oral probiotics are one of the postoperative treatments for rapid rehabilitation. However, there is a lack of prospective studies on this topic after appendectomy.

AIM

To investigate whether the postoperative probiotics can modulate the inflammatory response and restore intestinal function in patients following appendectomy.

METHODS

This was a prospective, randomized trial. A total of 60 emergency patients were randomly divided into a control group (n = 30) and a probiotic group (n = 30). Patients in the control group started to drink some water the first day after surgery, and those in the probiotic group were given water supplemented with Bacillus licheniformis capsules for 5 consecutive days postsurgery. The indices of inflammation and postoperative conditions were recorded, and the data were analyzed with RStudio 4.3.2 software.

RESULTS

A total of 60 participants were included. Compared with those in the control group, the C-reactive protein (CRP), interleukin 6 and procalcitonin (PCT) levels were significantly lower in the probiotic group at 2 d after surgery (P = 2.224e-05, P = 0.037, and P = 0.002, respectively, all P < 0.05). This trend persisted at day 5 post-surgery, with CRP and PCT levels remaining significantly lower in the probiotic group (P = 0.001 and P = 0.043, both P < 0.05). Furthermore, probiotics resulted in a shorter time to first flatus and a greater percentage of gram-negative bacilli in the feces (P = 0.035, P = 0.028, both P < 0.05).

CONCLUSION

Postoperative oral administration of probiotics may modulate the gut microbiota, benefit the recovery of the early inflammatory response, and subsequently enhance recovery after appendectomy.

Keywords: Probiotics, Gut microbiota, Appendectomy, Inflammatory markers, Intestinal function, Enhanced recovery after surgery, Postsurgical infections

Core Tip: This research examines the impact of administering oral probiotics postoperatively on inflammation responses and intestinal function in patients undergoing appendectomy procedures. Our findings reveal that orally administered probiotics effectively decrease postoperative inflammatory indicators and enhance intestinal functionality, thereby resulting in reduced hospitalization durations. These insights highlight the potential contribution of probiotics in expediting post-surgical recovery and offer novel approaches for clinical application.