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

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.