Effect of Perioperative Probiotics and Synbiotics on Postoperative Infections After Gastrointestinal Surgery: A Systematic Review With Meta‐Analysis

Yang, Zhiping; Wu, Qiong; Liu, Yunfang; Fan, Daiming

doi:10.1177/0148607116629670

Cited by 38 publications

(38 citation statements)

References 43 publications

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Section: Probiotics For Cgiscmentioning

confidence: 84%

“…Another meta-analysis that included 28 RCTs (n = 2511) involving adult patients undergoing gastrointestinal surgery came to similar conclusions (Yang et al, 2017). The durations of hospital stay and antibiotic therapy were shorter in the probiotics/symbiotic group vs controls (Yang et al, 2017). The need for caution in interpreting the results was emphasized considering the high risk of bias in included studies (Lytvyn et al, 2016;Yang et al, 2017).…”

Section: Probiotics For Cgiscmentioning

confidence: 92%

“… Evidence from studies in adult patients: A recent meta‐analysis of 20 RCTs ( N = 1374) concluded that probiotic/symbiotic supplementation decreases the risk of surgical site and urinary tract infections in patients undergoing abdominal surgery (Lytvyn et al ., ). Another meta‐analysis that included 28 RCTs ( n = 2511) involving adult patients undergoing gastrointestinal surgery came to similar conclusions (Yang et al ., ). The durations of hospital stay and antibiotic therapy were shorter in the probiotics/symbiotic group vs controls (Yang et al ., ).…”

Section: Probiotics For Cgiscmentioning

confidence: 97%

“…Another meta‐analysis that included 28 RCTs ( n = 2511) involving adult patients undergoing gastrointestinal surgery came to similar conclusions (Yang et al ., ). The durations of hospital stay and antibiotic therapy were shorter in the probiotics/symbiotic group vs controls (Yang et al ., ). The need for caution in interpreting the results was emphasized considering the high risk of bias in included studies (Lytvyn et al ., ; Yang et al ., ). Evidence from studies in paediatric patients: In a RCT, 30 children (<15 years) with various surgical (majority gastrointestinal) conditions were supplemented with probiotic Bifidobacterium breve BBG‐01 or placebo daily from 7 days before the surgery until discharge.…”

Section: Probiotics For Cgiscmentioning

confidence: 97%

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Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

Rao

Patole

2018

Microbial Biotechnology

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Summary Neonates with congenital gastrointestinal surgical conditions ( CGISC ) receive parenteral nutrition, get exposed to multiple courses of antibiotics, undergo invasive procedures, and are nursed in intensive care units. They do not receive early enteral feeding and have limited opportunities for skin to skin contact with their mothers. Many of these infants receive gastric acid suppression therapies. All these factors increase the risk of gut dysbiosis in these infants. Gut dysbiosis is known to be associated with increased risk of infections and other morbidities in ICU patients. Experimental studies have shown that probiotics inhibit gut colonization with pathogenic bacteria, enhance gut barrier function, facilitate colonization with healthy commensals, protect from enteropathogenic infection through production of acetate, reduce antimicrobial resistance, enhance innate immunity, and increase the maturation of the enteric nervous system and promote gut peristalsis. Through these mechanisms, probiotics have the potential to decrease the risk of sepsis and inflammation, improve feed tolerance and minimise cholestasis in neonates with CGISC . Among preterm non‐surgical infants, evidence from more than 35 RCT s and multiple observational studies have shown probiotics to be safe and beneficial. A RCT in neonates (N=24) with gastroschisis found that probiotic supplementation partially attenuated gut dysbiosis. Two ongoing RCT s (total N=168) in neonates with gastrointestinal surgical conditions are expected to provide feasibility data to enable the conduct of large RCT s. Rigorous quality assurance of the probiotic product, ongoing microbial surveillance and clinical vigilance are warranted while conducting such RCT s.

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Section: Probiotics For Cgiscmentioning

confidence: 84%

Section: Probiotics For Cgiscmentioning

confidence: 92%

Section: Probiotics For Cgiscmentioning

confidence: 97%

Section: Probiotics For Cgiscmentioning

confidence: 97%

See 2 more Smart Citations

Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

Rao

Patole

2018

Microbial Biotechnology

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“…A recently performed systematic review with metanalysis of 28 randomized controlled trials involving 2511 patients revealed that the use of these substances has the potential to reduce the incidence of wound infections. (27) Specifically, studies using combination of two or more probiotic strains were associated with significant outcomes. This is of no surprise, as one bacterial strain is unlikely to promote reinstatement of the complex community structure and function of the health-promoting intestinal microbiome.…”

Section: Intestinal Microbiome and Surgical Site Infectionsmentioning

confidence: 99%

The role of the microbiota in surgical recovery

Krezalek

Alverdy²

2016

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of review The purpose of this review is to highlight new research findings in the complex bidirectional crosstalk that occurs between the intestinal microbiome and the host immune system in the context of surgical recovery and outcomes. Recent findings Significant evidence has been generated emphasizing the central role of the intestinal microbiome on surgical outcomes such as wound healing, surgical site infections and anastomotic leak. Current preventive strategies including the use of some parenteral antibiotics, may actually exacerbate the problem by selecting for drug-resistant pathogens. Summary A delicate balance exists between the human host and its microbial counterparts that is directly related to post-surgical healing. This balance can be easily altered in favor of the pathogen through peri-operative and surgical interventions leading to intestinal dysbiosis and loss of colonization resistance. Current strategies to prevent infectious complications with the escalating use of broader and more powerful antibiotics is not an evolutionarily stable strategy. A more complete understanding of the ecological and molecular interactions of the host with its microbiome is necessary to uncover new therapeutic strategies that preserve the composition and function of the intestinal microbiome and constrain virulent pathogens through the course of surgical injury.

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Current evidence of nutritional therapy in pancreatoduodenectomy: Systematic review of randomized controlled trials

Takagi

Domagała

Hartog

et al. 2019

Annals of Gastroent Surgery

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Aim: Evidence of nutritional therapies in pancreatoduodenectomy (PD) has been shown. However, few studies focus on the association between different nutritional therapies and outcomes. The aim of this review was to summarize the current evidence of nutritional therapies such as enteral nutrition (EN), immunonutrition, and synbiotics on postoperative outcomes after PD. Methods:A systematic literature search of Embase, Medline Ovid, and Cochrane CENTRAL was done to summarize the available evidence, including randomized controlled trials, meta-analyses and reviews, regarding nutritional therapy in PD. Results:A total of 20 randomized controlled trials were included in this review. Safety and tolerability of EN in PD was shown. Giving postoperative EN can shorten length of stay compared to parenteral nutrition; however, the effect of EN on postoperative complications remains controversial. Postoperative EN should be given only on selective indications rather than routinely used, and preoperative EN is indicated only in patients with severe malnutrition. Giving preoperative immunonutrition is considered to reduce the incidence of infectious complications; however, evidence level is moderate and recommendation grade is weak. The beneficial effect of perioperative synbiotics on postoperative infectious complications is limited. Furthermore, the effectiveness of other nutritional supplements remains unclear. Conclusion:Recently, evidence of enhanced recovery after surgery (ERAS) in PD has been increasing. Early oral intake with systematic nutritional support is an important aspect of the ERAS concept. Future well-designed studies should investigate the impact of systematic nutritional therapies on outcomes following PD. K E Y W O R D Senteral nutrition, immunonutrition, nutritional intervention, pancreatoduodenectomy, synbiotics | 621 TAKAGI eT Al.

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Effect of Perioperative Probiotics and Synbiotics on Postoperative Infections After Gastrointestinal Surgery: A Systematic Review With Meta‐Analysis

Abstract: Probiotics and synbiotics may prevent postoperative infections in patients undergoing gastrointestinal surgery. However, the results need to be interpreted with caution due to the risk of bias in the included studies and the potential publication bias.

Cited by 38 publications

References 43 publications

Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

Probiotic research in neonates with congenital gastrointestinal surgical conditions – Now is the time

The role of the microbiota in surgical recovery

Current evidence of nutritional therapy in pancreatoduodenectomy: Systematic review of randomized controlled trials

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