Probiotics for preventing postoperative infection in colorectal cancer patients: a systematic review and meta-analysis

Int J Colorectal Dis. 2019 Mar;34(3):459-469. doi: 10.1007/s00384-018-3214-4. Epub 2018 Dec 11.

Abstract

Purpose: Postoperative infection has seriously affected the prognosis of cancer patients, while probiotics have been increasingly used to prevent postoperative infection in clinical practice. This study aimed to evaluate the preventive effect of probiotics on infection after colorectal cancer (CRC) surgery.

Methods: Related clinical trial reports were collected from Pubmed, Embase, Cochrane Library as well as China National Knowledge Infrastructure (CNKI) databases. These reports were then strictly screened, and information as well as data were extracted. Finally, the enrolled studies were evaluated by systematic review and meta-analysis using STATA v11 and Revman v5.2.

Results: Probiotics administration contributed to the reduction of overall infection rate after colorectal surgery, with a pooled odds ratio (OR) of 0.51 (95% CI: 0.38-0.68, P = 0.00). Meanwhile, the incidence of incision infection (pooled OR = 0.59, 95% CI 0.39-0.88, P = 0.01) and pneumonia (pooled OR = 0.56, 95% CI 0.32-0.98, P = 0.04) as well as the first flatus time (SMDs = - 0.70, 95% CI - 1.13-- 0.27, P = 0.002) were also reduced by probiotics. In addition, urinary tract infection, anastomotic leakage, and duration of postoperative pyrexia were also analyzed, which displayed no statistical differences compared with those of control.

Conclusion: Probiotics have potential efficacy on preventing postoperative infection and related complications in cancer patients undergoing colorectal surgery.

Keywords: Colorectal surgery; Meta-analysis; Postoperative infection; Probiotics.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Colorectal Neoplasms / complications*
  • Colorectal Neoplasms / surgery*
  • Humans
  • Odds Ratio
  • Probiotics / therapeutic use*
  • Publication Bias
  • Surgical Wound Infection / etiology*
  • Surgical Wound Infection / prevention & control*