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

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.

Microbiome First Medicine in Health and Safety

“…Table 4 illustrates examples from human clinical trials [ 131 , 148 , 149 , 150 , 151 , 152 , 153 , 154 , 155 , 156 , 157 , 158 , 159 , 160 , 161 , 162 , 163 , 164 , 165 , 166 , 167 , 168 , 169 , 170 , 171 , 172 , 173 , 174 , 175 , 176 , 177 , 178 , 179 , 180 , 181 , 182 , 183 ]. Not surprisingly, the best outcomes occur when there is a clear understanding of the specific microbes, genes, metabolic changes, and installation conditions that are needed to support microbiome-driven physiological benefits.…”

Effects of probiotics on gastric cancer‐related inflammation: A systematic review and meta‐analysis

“…In recent years, probiotics have gradually become a hot spot in general surgery research (Pitsillides et al, 2021;Zhang et al, 2021).…”

“…In recent years, probiotics have gradually become a hot spot in general surgery research (Pitsillides et al., 2021; Zhang et al., 2021). Past meta‐analysis literature showed that probiotics reduced infection and inflammatory reactions in patients after colorectal cancer surgery.…”

The Dark Side of Iron: The Relationship between Iron, Inflammation and Gut Microbiota in Selected Diseases Associated with Iron Deficiency Anaemia—A Narrative Review

“…Attempts have been made to use probiotics in the treatment of colorectal cancer and to reduce the risk of its development. The analysis of randomised trials shows that using probiotics, especially Lactobacilli and Bifidobacterium species, reduces postoperative complications and accelerates patient recovery [ 118 ]. Faghfoori et al proved that some Bifidobacteria species produce substances that affect the activation of apoptotic pathways in human colorectal cancer cells (HT-29 and Caco-2 cell lines) but highlighted the need for further research in this area [ 119 ].…”