Effects of Oral Probiotics on Inflammation and Intestinal Function in Adult Patients After Appendectomy: Randomized Controlled Trial

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 ( = 30) and a probiotic group ( = 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 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 ( = 2.224e-05, = 0.037, and = 0.002, respectively, all < 0.05). This trend persisted at day 5 post-surgery, with CRP and PCT levels remaining significantly lower in the probiotic group ( = 0.001 and = 0.043, both < 0.05). Furthermore, probiotics resulted in a shorter time to first flatus and a greater percentage of gram-negative bacilli in the feces ( = 0.035, = 0.028, both < 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.