Abstract
Objective The objective of this study was to conduct a systematic review and meta-analysis about probiotics to improve postoperative infections in patients undergoing colorectal cancer surgery. Methods The PubMed and the Web of Science were used to search for appropriate randomized clinical trials (RCTs) comparing probiotics with placebo for the patients undergoing colorectal cancer surgery. The RevMan 5.3 was performed for meta-analysis to evaluate the postoperative infection, including the total infection, surgical site infection, central line infection, pneumonia, urinary tract infection, septicemia, and postoperative leakage. Results Our meta-analysis included 6 studies involving a total of 803 patients. For the incidence of total postoperative infection (odd ratios (OR) 0.31, 95% confidence interval (CI) 0.15–0.64, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, I2 = 0%), surgical site infection (OR 0.62, 95% CI 0.39–0.99, Conclusions Probiotics is beneficial to prevent postoperative infections (including total postoperative infection, surgical site infection, pneumonia, urinary tract infection, and septicemia) in patients with colorectal cancer.
Highlights
E probiotics therapy, which was introduced by Lilly and Stillwell [3], could lead to positive clinical and laboratorial outcomes for patients undergoing gastrointestinal surgery
Probiotics are live microorganisms and it is known that probiotics benefit to the host as they can stabilize the intestinal microbiological environment
We try to explore the incidence of post-operative infections, including the incidence of the total infection and subgroup infection, such as surgical site infection, central line infection, pneumonia, urinary tract infection, septicemia and postoperative leakage
Summary
For the incidence of pneumonia, our study enrolled 4 studies, including a total of 508 patients, and the result showed that probiotics was significantly lower than the placebo (OR 0.36, 95%CI 0.18–0.71, 퐼2 = 0%). For the result of the incidence of septicemia, our study enrolled 4 studies, including a total of 509 patients, and the result showed that probiotics was significantly lower than the placebo (OR 0.28, 95%CI 0.17–0.47, 퐼2 = 10%). For the result of the incidence of postoperative leakage, our study enrolled 3 studies, including a total of 419 patients, and the result did not show that probiotics was significantly lower than the placebo (OR 0.45, 95%CI 0.06–3.27, 퐼2 = 68%). Potential publication bias of probiotics used for surgical site infection was performed and shown as funnel plot (Figure 11)
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