Han Yue, Wang Yong, Guan Min
Department of Gastrointestinal Surgery, Shandong Provincial Third Hospital, Shandong University, Jinan 250031, Shandong Province, China.
Department of Hepatobiliary Surgery, Shandong Provincial Third Hospital, Shandong University, Jinan 250031, Shandong Province, China.
World J Gastrointest Surg. 2024 Nov 27;16(11):3546-3558. doi: 10.4240/wjgs.v16.i11.3546.
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.
To synthesize the available evidence regarding the prophylactic efficacy of probiotics in preventing infections following CRC surgery.
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.
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.
Probiotics have demonstrated potential in mitigating postoperative infectious complications among patients undergoing CRC surgery.
术后感染仍然是接受结直肠癌(CRC)手术患者发病的一个重要来源。虽然益生菌已被提议作为降低这些感染风险的一种潜在策略,但当代的荟萃分析结果却相互矛盾。
综合关于益生菌预防CRC手术后感染的预防效果的现有证据。
对PubMed和Scopus进行全面检索,以确定截至2024年2月发表的相关荟萃分析。为了评估益生菌对结局的疗效,使用随机效应模型汇总相对风险(RR)及其相应的95%置信区间(CI)。
这项全面的综合荟萃分析纳入了11项荟萃分析,涉及11518名符合纳入标准的参与者。服用益生菌导致总感染发生率有统计学意义的降低(RR:0.40,95%CI:0.31 - 0.51;中等确定性)、手术部位感染(RR:0.56,95%CI:0.49 - 0.63;高确定性)、肺炎(RR:0.38,95%CI:0.30 - 0.48;高确定性)、尿路感染(RR:0.44,95%CI:0.31 - 0.61;中等确定性)、菌血症(RR:0.41,95%CI:0.30 - 0.56;高确定性)和脓毒症(RR:0.35,95%CI:0.25 - 0.44;高确定性)。然而,益生菌对腹腔内、中心静脉或腹膜感染没有显著影响。
益生菌已显示出减轻CRC手术患者术后感染并发症的潜力。