To evaluate the effect of perioperative probiotic administration on the incidence of overall postoperative infective complications and specific outcomes, such as wound infection, in patients undergoing gastrointestinal surgery.
Key Findings:
Pooled analysis suggested a potential benefit in reducing overall postoperative infections (OR: 0.57; P = 0.057).
Statistically significant reduction in postoperative infections with multi-strain Lactobacillus and Bifidobacterium formulations (RR: 0.64; P < 0.01).
Absolute risk reduction (ARR) for multi-strain subgroup was 13.5%, with a number needed to treat (NNT) of 7.
Interpretation:
While the overall efficacy of perioperative probiotics narrowly missed statistical significance, specific multi-strain formulations showed a clinically meaningful reduction in infectious complications.
Limitations:
The overall effect narrowly missed statistical significance.
The search may not have comprehensively captured studies using alternative probiotic organisms.
Conclusion:
Targeted use of multi-strain Lactobacillus and Bifidobacterium formulations is recommended for inclusion in Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing major gastrointestinal surgery.
