Perioperative or Postoperative Probiotics Reduce Treatment-Related Complications in Adult Colorectal Cancer Patients Undergoing Surgery: A Systematic Review and Meta-analysis

Jorge Eduardo Persson; Patricia Viana; Marina Persson; Jessica H Relvas; Lucineia G Danielski

doi:10.1007/s12029-024-01016-8

Perioperative or Postoperative Probiotics Reduce Treatment-Related Complications in Adult Colorectal Cancer Patients Undergoing Surgery: A Systematic Review and Meta-analysis

J Gastrointest Cancer. 2024 Jan 17. doi: 10.1007/s12029-024-01016-8. Online ahead of print.

Authors

Jorge Eduardo Persson^#¹, Patricia Viana^#¹, Marina Persson², Jessica H Relvas³, Lucineia G Danielski⁴

Affiliations

¹ Department of Medicine, Universidade do Extremo Sul Catarinense, Criciuma, Brazil.
² Department of Medicine, Universidade Federal de Pelotas, Pelotas, Brazil.
³ Department of Internal Medicine, Conjunto Hospitalar do Mandaqui, São Paulo, Brazil.
⁴ Postgraduate Program in Health Sciences, Universidade do Extremo Sul Catarinense, Criciuma, Brazil. lucigdanielski@gmail.com.

^# Contributed equally.

PMID: 38231290
DOI: 10.1007/s12029-024-01016-8

Abstract

Purpose: This systematic review and meta-analysis of randomized controlled trials (RCTs) aimed to assess the efficacy of perioperative or postoperative probiotics as a therapeutic approach for managing colorectal cancer treatment-related complications in patients undergoing surgery, with or without adjuvant therapy.

Methods: MEDLINE, Embase, and Scopus databases were searched.

Results: Ten RCTs with 1276 patients were included. There was a significant decrease in the incidence of diarrhea (odds ratio (OR) 0.42; 95% CI 0.31 to 0.55; p < 0.001), surgical site infection (OR 0.44; 95% CI 0.22 to 0.89; p = 0.023), urinary infection (OR 0.43; 95% CI 0.20 to 0.91; p = 0.028), pulmonary infection (OR 0.30; 95% CI 0.15 to 0.60; p < 0.001), abdominal distention (OR 0.43; 95% CI 0.25 to 0.76; p = 0.004), length of ATB therapy (mean difference (MD) - 1.66 days; 95% CI - 2.13 to - 1.19 days; p < 0.001), and duration of postoperative pyrexia (MD - 0.80 days; 95% CI - 1.38 to - 0.22 days; p = 0.007) in the probiotic group. Nevertheless, length of hospital stay, time to first defecation, and time to first solid diet were not different between groups.

Conclusion: Our findings suggest that perioperative or postoperative probiotics is effective for reducing treatment-related complications in patients with colorectal cancer undergoing surgery, with a lower rate of adverse events.

Keywords: Colorectal cancer; Gut microbiota; Meta-analysis; Probiotics.