Do Perioperative Probiotics/Synbiotics Reduce Postoperative Infection Rates Following Elective Colorectal Surgery? A Systematic Review and Meta-Analysis

IF 1.7 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2025-06-27 DOI:10.1016/j.jss.2025.05.026

Claudia Paterson MBChB , Amanda Nikolic MBChB, FRACS , Tamara Glyn MBChB, FRACS , Tim Eglinton MBChB, MMedSc, FRACS , Parry Singh MBChB, PhD, FRACS , Andrew Hill MBChB, MD, FRACS, FRSNZ

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引用次数: 0

Abstract

Introduction

Postoperative infections remain common in elective colorectal surgery (CRS). Perioperative probiotics/synbiotics have been investigated as a strategy to optimize the intestinal microbiota and reduce postoperative infections. The aim of this study was to conduct an updated systematic review and meta-analysis on the efficacy of perioperative probiotics/synbiotics on postoperative infection rates following elective CRS.

Methods

Six databases were searched on February 7, 2023, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines (International Prospective Register of Systematic Reviews: CRD420233392754). Inclusion criteria: randomized controlled trials comparing perioperative probiotics or synbiotics in colorectal resection for malignant or benign disease in patients > 18 y, reporting data on infectious complications within 30 d of surgery. Exclusion criteria: patients undergoing acute colorectal resection, nonrandomized controlled trials, prebiotics alone used as the intervention or control. The primary outcome measure was total postoperative infection rates within 30 d of elective CRS.

Results

Twenty-eight randomized controlled trials involving 2686 participants demonstrated an association between probiotics/synbiotics and reduced rates of total postoperative infections within 30 d of elective CRS (relative risk 0.55, 95% confidence interval 0.41-0.74, P < 0.001).

Conclusions

Perioperative probiotics/synbiotics are associated with almost halved total postoperative infection rates within 30 d of elective CRS. Further investigation into optimal regimens and the confounding effect of modern colorectal surgical practice is essential prior to implementation into clinical practice.

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围手术期益生菌/合成菌能降低择期结直肠癌术后感染率吗？系统回顾和荟萃分析

术后感染在择期结肠手术（CRS）中仍然很常见。围手术期益生菌/合成菌已被研究作为优化肠道菌群和减少术后感染的策略。本研究的目的是对围手术期益生菌/合成菌对选择性CRS术后感染率的影响进行最新的系统回顾和荟萃分析。方法根据系统评价和meta分析2020指南（国际前瞻性系统评价注册：CRD420233392754）的首选报告项目，于2023年2月7日检索6个数据库。纳入标准：随机对照试验，比较结肠直肠癌恶性或良性疾病患者围手术期使用益生菌或合成菌；18 .报告手术后30天内感染并发症的数据。排除标准：急性结直肠切除术患者，非随机对照试验，单独使用益生元作为干预或对照。主要结局指标是择期CRS术后30天内的总感染率。结果28项随机对照试验（涉及2686名受试者）显示，益生菌/合成菌与选择性CRS术后30天内总感染率降低有关(相对危险度0.55,95%可信区间0.41-0.74,P <；0.001)。结论择期CRS术后30 d内益生菌/合成菌可使总感染率降低近一半。在实施到临床实践之前，进一步研究最佳方案和现代结直肠手术实践的混杂效应是必不可少的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.