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Probiotics and Synbiotics Decrease Postoperative Sepsis in Elective Gastrointestinal Surgical Patients: a Meta-Analysis

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

The health benefits of probiotics and synbiotics are well established in healthy adults, but their role in preventing postoperative sepsis remains controversial. This meta-analysis assesses the impact of probiotics and synbiotics on the incidence of postoperative sepsis in gastrointestinal (GI) surgical patients.

Methods

A comprehensive literature search of all published randomized control trials (RCTs) was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (1966–2015). Inclusion criteria included RCTs comparing the use of any strain or dose of a specified probiotic/synbiotic with placebo or a “no treatment” control group. The incidence of postoperative sepsis (within 1 month of surgery) and postoperative mortality were analyzed.

Results

Fifteen RCTs involving 1201 patients (192 receiving probiotics, 413 receiving synbiotics, and 596 receiving placebo) were analyzed. Overall, probiotic and synbiotic uses significantly reduced the risk of developing postoperative sepsis by 38 % (relative risk (RR) = 0.62, 95 % confidence interval (CI) 0.52–0.74, p < 0.001).

Conclusions

The use of probiotic/synbiotic supplementation is associated with a significant reduction in the risk of developing postoperative sepsis in patients undergoing elective GI surgery. Probiotic/synbiotic supplementation is a valuable adjunct in the care of patients undergoing GI surgery. Additional studies are required to determine the optimal dose and strain of probiotic/synbiotic.

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Authors and Affiliations

  1. Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ, 07039, USA

    Sudha Arumugam, Christine S. M. Lau & Ronald S. Chamberlain

  2. Department of Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA

    Ronald S. Chamberlain

  3. Saint George’s University School of Medicine, True Blue, Grenada, West Indies

    Christine S. M. Lau & Ronald S. Chamberlain

Authors
  1. Sudha Arumugam
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  2. Christine S. M. Lau
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  3. Ronald S. Chamberlain
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Correspondence to Ronald S. Chamberlain.

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Arumugam, S., Lau, C.S.M. & Chamberlain, R.S. Probiotics and Synbiotics Decrease Postoperative Sepsis in Elective Gastrointestinal Surgical Patients: a Meta-Analysis. J Gastrointest Surg 20, 1123–1131 (2016). https://doi.org/10.1007/s11605-016-3142-y

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  • DOI: https://doi.org/10.1007/s11605-016-3142-y

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