The Effect of Perioperative Administration of Probiotics on Colorectal Cancer Surgery Outcomes.

Department of Surgery and Cancer, South Kensington Campus, Imperial College London, London SW7 2AZ, UK. Department of Advanced Medical and Surgical Sciences, Università degli Studi della Campania Luigi Vanvitelli, 80138 Naples, Italy. Colorectal Surgery, Vall d'Hebron University Hospital, 08035 Barcelona, Spain. Department of Colorectal Surgery, Chelsea and Westminster Hospital, London SW10 9NH, UK. Department of Colorectal Surgery, Royal Marsden Hospital, London SW3 6JJ, UK.

Nutrients. 2021;(5)
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Abstract

The perioperative care of colorectal cancer (CRC) patients includes antibiotics. Although antibiotics do provide a certain protection against infections, they do not eliminate them completely, and they do carry risks of microbial resistance and disruption of the microbiome. Probiotics can maintain the microbiome's balance postoperatively by maintaining intestinal mucosal integrity and reducing bacterial translocation (BT). This review aims to assess the role of probiotics in the perioperative management of CRC patients. The outcomes were categorised into: postoperative infectious and non-infectious complications, BT rate analysis, and intestinal permeability assessment. Fifteen randomised controlled trials (RCTs) were included. There was a trend towards lower rates of postoperative infectious and non-infectious complications with probiotics versus placebo. Probiotics reduced BT, maintained intestinal mucosal permeability, and provided a better balance of beneficial to pathogenic microorganisms. Heterogeneity among RCTs was high. Factors that influence the effect of probiotics include the species used, using a combination vs. single species, the duration of administration, and the location of the bowel resection. Although this review provided evidence for how probiotics possibly operate and reported notable evidence that probiotics can lower rates of infections, heterogeneity was observed. In order to corroborate the findings, future RCTs should keep the aforementioned factors constant.

Methodological quality

Publication Type : Review

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