Editorial
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Aug 27, 2025; 17(8): 106860
Published online Aug 27, 2025. doi: 10.4240/wjgs.v17.i8.106860
Bifidobacterium triple viable bacteria-assisted mirtazapine in gastric cancer postoperative rehabilitation
Zong-Yang Li, Zhi-Cheng Liu, Yu-Ning Gao, Ying Zhao, Chun-Hua Bai, Peng Xiao, Di-Fei Wang, Hong-Qiao Cai
Zong-Yang Li, Hong-Qiao Cai, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Zhi-Cheng Liu, Department of Gastrointestinal Surgery, General Surgery Center, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Yu-Ning Gao, Department of Gastrointestinal Surgery, Changchun Central Hospital, Changchun 130000, Jilin Province, China
Ying Zhao, Department of Psychiatry, Changchun Sixth Hospital, Changchun 130000, Jilin Province, China
Chun-Hua Bai, Department of Oncology, Shenzhen Qianhai Taikang Hospital, Shenzhen 518055, Guangdong Province, China
Peng Xiao, Department of Neurosurgery, Baicheng Central Hospital, Baicheng 137000, Jilin Province, China
Di-Fei Wang, Department of Radiology, The First Hospital of Jilin University, Changchun 130000, Jilin Province, China
Author contributions: Li ZY contributed to the discussion and design of the manuscript; Li ZY, Liu ZC, Gao YN, Zhao Y, Bai CH, Xiao P, Wang DF, and Cai HQ contributed to the writing, and editing the manuscript, illustrations, and review of literature; Cai HQ designed the overall concept and outline of the manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Hong-Qiao Cai, MD, PhD, Department of Hepatobiliary and Pancreatic Surgery, General Surgery Center, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. hongqiaocai@jlu.edu.cn
Received: March 10, 2025
Revised: March 30, 2025
Accepted: April 22, 2025
Published online: August 27, 2025
Processing time: 169 Days and 1.5 Hours
Abstract

This article discusses the original article published by Lu et al in the latest issue. The article confirmed through a cohort study the clinical efficacy of the triple live bacteria of Bifidobacterium combined with mirtazapine in treating postoperative depression of gastric cancer patients, also explored the multi-target therapeutic mechanisms of Bifidobacterium triple viable bacteria combined with mirtazapine in managing depression in patients after radical gastrectomy for gastric cancer for the first time. The results indicated that Bifidobacterium could alleviate depression in patients after radical gastrectomy for gastric cancer. Gastric cancer patients undergoing surgery frequently experience postoperative psychological disorders, notably depression. These conditions not only impair quality of life but also negatively impact disease-free and overall survival. This editorial explores the underestimated psychological challenges following gastric cancer surgery, including depression, anxiety, adjustment disorders, and post-traumatic stress disorder. It further examines the therapeutic potential of Bifidobacterium triple viable probiotics, combined with mirtazapine, in alleviating postoperative depression through microbiological, immunological, and neurological mechanisms. Clinical evidence highlights additional benefits, such as improved gastrointestinal function, enhanced immunity, and better nutritional status, underscoring a holistic approach to postoperative care. While promising, further large-scale trials are needed to optimize and personalize probiotic-based interventions.

Keywords: Bifidobacterium triple bacteria; Mirtazapine; Radical gastric cancer; Depression; Mechanisms

Core Tip: Postoperative depression in gastric cancer patients significantly influences recovery, which links to reduced survival. Bifidobacterium triple viable probiotics, alongside mirtazapine, offer a multifaceted treatment strategy by restoring gut microbiota, modulating immunity, and regulating the microbiota-gut-brain axis to alleviate depression. Beyond mental health, these probiotics enhance gastrointestinal function, immunity, and nutrition, supporting comprehensive postoperative recovery. Personalized regimens based on gut microbiota profiles could further improve outcomes, to achieve the greatest possible improvement in the depression status of patients after gastric cancer surgery.