Probiotics reduce postoperative infections in patients undergoing colorectal surgery: A systematic review and meta-analysis
Open accessAbstract
Background.We performed this meta-analysis to investigate the efficacy of probiotics on prevention of infection-related complications following colorectal resection.Method.PubMed, EMBASE, Cochrane Library, and the Web of Science were searched up to January 2016. According to the results, only randomized controlled trials that compared the efficacy of probiotics on patients with colorectal resection were included for meta-analysis.Results.Nine studies including a total of 1146 patients met the criteria (556 received multistrain probiotic bacteria, 590 with non-multistrain probiotic bacteria). The combination of multistrain probiotics was beneficial in the reduction of total infections (OR = 0.30, 95%CI: 0.15–0.61, p=0.0009 ), including surgical site infections (SSI) (OR = 0.48, 95%CI: 0.25–0.89, p=0.02 ) and nonsurgical site infections (NSSI) (OR = 0.36, 95%CI: 0.23–0.56, p<0.00001 ). However, there was no significant reduction in total infections (OR = 0.74, 95%CI: 0.50–1.09, p=0.13 ) or SSI (OR = 0.77, 95%CI: 0.52–1.12, p=0.17 ) with the application of non-multistrains of probiotics.Conclusion.Combinations of multistrain probiotic bacteria showed promise in preventing the incidence of infections following colorectal surgery. However, the efficacy of one or two strains of probiotics remains undetermined.
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Studies show a wide range of probiotic doses, from 10^8 to 10^11 cells or CFU, and different administration forms may cause further differences.
“For example, studies show a wide range of doses, ranging from 108 to 1011 cells or CFU, and different forms of administration (cheese, yogurt and milk, or probiotic capsule) may also cause further differences [14,15].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [14]
The Discussion reports that doses varied among nine colorectal-surgery trials, including examples of 10^8 and at least 10^11 CFU/g. It also says formulations may function differently, but does not address the claimed administration forms—cheese, yogurt, milk, or probiotic capsules—or show that those forms cause further differences. The cited quantities are concentrations (CFU/g), not necessarily total doses in cells or CFU. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn some probiotic studies, the duration of exposure of 3-6 weeks may have been insufficient to detect changes.
“In some studies, the duration of exposure (3–6 weeks) may have been insufficient to detect changes [14,15].”
From Current Concepts in Probiotic Safety and Efficacy (2026) · cites this paper as [14]
The Discussion reports that only treatment lasting more than 10 days showed significant efficacy for incision infections, which offers limited support for the possibility that duration matters. It does not discuss 3–6 weeks as insufficient to detect changes; it also says both duration groups improved total infections and that no reliable conclusion about treatment duration can be made. Page numbers are unavailable in our copy. (LLM, conf=0.79)
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References 51 · Cited by 49
- Authors
- Liu, P. C., Yan, Y. K., Ma, Y. J., Wang, X. W., Geng, J., Wang, M. C., Wei, F. X., Zhang, Y. W., Xu, X. D., & Zhang, Y. C.
- Affiliations
- Lanzhou University Second Hospital (CN)
- Department of General Surgery, Lanzhou University Second Hospital, Lanzhou 730030, China
- Corresponding author
- Zhang, You Cheng
- Venue
- Gastroenterology Research and Practice
- Publisher
- Wiley
- Published
- 2017
- Volume
- 2017
- Pages
- 1-9
- ISSN
- 1687-6121 (ISSN-L)
- 1687-630X
- PMC
- PMC5397731
- OpenAlex
- W2605222927
- Cited by
- 49
- References
- 51
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 10 · 2020: 2 · 2019: 3 · 2018: 5 · 2017: 3
- FWCI
- 0.39
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Gastroenterology Research and Practice (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Lanzhou University Institutional Repository (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- Lanzhou University Teaching Research Project (201420)
- Topics
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Health Sciences › Medicine › Surgery › Surgical site infection prevention
- Health Sciences › Medicine › Surgery › Enhanced Recovery After Surgery
- Keywords
- probiotics, colorectal surgery, postoperative infection, surgical site infection, multi-strain probiotics, infection control, colorectal resection
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