Preventive effect of probiotics on infections following colorectal cancer surgery: An umbrella meta-analysis

doi:10.4240/wjgs.v16.i11.3546

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World Journal of Gastrointestinal Surgery

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1948-9366

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Meta-Analysis

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.

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.

Keywords: Probiotics; Colorectal cancer Surgery; Postoperative infections; Pneumonia; Urinary tract infections; Bacteremia; Sepsis; Meta-analysis

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.