Han Y, Wang Y, Guan M. Preventive effect of probiotics on infections following colorectal cancer surgery: An umbrella meta-analysis. World J Gastrointest Surg 2024; 16(11): 3546-3558 [DOI: 10.4240/wjgs.v16.i11.3546]
Corresponding Author of This Article
Min Guan, PhD, Doctor, Department of Gastrointestinal Surgery, Shandong Provincial Third Hospital, Shandong University, No. 11 Middle Wuyingshan Road, Tianqiao District, Jinan 250031, Shandong Province, China. gmindoc@163.com
Research Domain of This Article
Pediatrics
Article-Type of This Article
Meta-Analysis
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2024; 16(11): 3546-3558 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3546
Preventive effect of probiotics on infections following colorectal cancer surgery: An umbrella meta-analysis
Yue Han, Yong Wang, Min Guan
Yue Han, Min Guan, Department of Gastrointestinal Surgery, Shandong Provincial Third Hospital, Shandong University, Jinan 250031, Shandong Province, China
Yong Wang, Department of Hepatobiliary Surgery, Shandong Provincial Third Hospital, Shandong University, Jinan 250031, Shandong Province, China
Co-first authors: Yue Han and Yong Wang.
Author contributions: Han Y was responsible for conceptualization, methodology, investigation, writing-original draft, writing-review and editing, visualization; Wang Y was responsible for methodology, investigation, resources, software, formal analysis, data curation, writing original draft, visualization; Guan M was responsible for supervision, methodology, conceptualization, project administration, investigation, writing-review and editing. All authors have read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Min Guan, PhD, Doctor, Department of Gastrointestinal Surgery, Shandong Provincial Third Hospital, Shandong University, No. 11 Middle Wuyingshan Road, Tianqiao District, Jinan 250031, Shandong Province, China. gmindoc@163.com
Received: May 9, 2024 Revised: August 7, 2024 Accepted: September 9, 2024 Published online: November 27, 2024 Processing time: 174 Days and 2.4 Hours
Abstract
BACKGROUND
Postoperative infections remain a significant source of morbidity among patients undergoing colorectal cancer (CRC) surgery. While probiotics have been proposed as a potential strategy to mitigate the risk of these infections, contemporary meta-analyses have produced conflicting findings.
AIM
To synthesize the available evidence regarding the prophylactic efficacy of probiotics in preventing infections following CRC surgery.
METHODS
A comprehensive search of PubMed and Scopus was conducted to identify relevant meta-analyses published up to February 2024. To assess the efficacy of probiotics on outcomes, relative risks (RR) and their corresponding 95%CI were pooled using a random effects model.
RESULTS
This comprehensive umbrella meta-analysis integrated eleven meta-analyses encompassing 11518 participants who fulfilled the inclusion criteria. Probiotics administration resulted in a statistically significant reduction in the incidence of total infections (RR: 0.40, 95%CI: 0.31-0.51; moderate certainty), surgical site infections (RR: 0.56, 95%CI: 0.49-0.63; high certainty), pneumonia (RR: 0.38, 95%CI: 0.30-0.48; high certainty), urinary tract infections (RR: 0.44, 95%CI: 0.31-0.61; moderate certainty), bacteremia (RR: 0.41, 95%CI: 0.30-0.56; high certainty), and sepsis (RR: 0.35, 95%CI: 0.25-0.44; high certainty). However, probiotics did not significantly affect intra-abdominal, central line, or peritoneal infections.
CONCLUSION
Probiotics have demonstrated potential in mitigating postoperative infectious complications among patients undergoing CRC surgery.
Core Tip: This meta-analysis of 11 studies involving 11518 colorectal cancer (CRC) patients found that probiotics significantly reduce postoperative infection rates, including surgical site infections, pneumonia, urinary tract infections, bacteremia, and sepsis. Probiotics were particularly effective in preventing these complications, demonstrating minimal efficacy against intra-abdominal, central line, and peritoneal infections. These findings support the integration of probiotics into post-CRC surgery prevention strategies.
