title: Use of pro-/synbiotics as prophylaxis in patients undergoing colorectal resection for cancer: a meta-analysis of randomized controlled trials.
abstract: OBJECTIVE
  To estimate the efficacy of pro-/synbiotics treatment in patients undergoing colorectal resection, a meta-analysis of randomized controlled trials was conducted.
  
  
  METHODS
  An electronic search of PubMed, MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Academic Search Premier, and China National Knowledge Infrastructure was performed, and RevMan 5.0 was used for statistical analysis.
  
  
  RESULTS
  Six studies including 361 patients undergoing elective colorectal surgery were retrieved. The combined analysis revealed that perioperative pro-/synbiotics administration had a positive effect on the incidence of diarrhea (OR 0.29, 95% CI 0.14 to 0.62, P=0.001), the incidence of symptomatic intestinal obstructions (OR 0.39, 95% CI 0.19 to 0.78, P=0.008), the incidence of operative total infections (OR 0.39, 95% CI: 0.22 to 0.68, P=0.0010), and pneumonia infection (OR 0.32, 95% CI 0.11 to 0.93, P=0.04). The regimen increased the numbers of Lactobacillus (MD 2.66, 95% CI: 2.13 to 3.18; P<0.00001), and decreased the counts of Enterobacteriaceae (MD -1.52, 95% CI: -1.93 to -1.11, P<0.00001). No significant differences were found between the two groups in septic morbidity, incision infection, perineal infection, intraabdominal infection, anastomotic leak, the first defecation time, length of hospital stay, mesenteric lymph nodes for bacterial translocation. No mortality related to pro-/synbiotics treatment was revealed in all studies.
  
  
  CONCLUSIONS
  Based on the meta-analysis, perioperatively use pro-/synbiotics as prophylaxis in patients undergoing colorectal resection improved clinical outcomes. The best preventive strategy (including species and the optimal dose) of pro-/synbiotics should be considered in future meta-analyses.
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu 610041, Sichuan Province, China.
authors.forename: Dan
authors.initials: D
authors.lastname: He
authors.forename: Hai-Yang
authors.initials: HY
authors.lastname: Wang
authors.forename: Jing-Yan
authors.initials: JY
authors.lastname: Feng
authors.forename: Ming-Ming
authors.initials: MM
authors.lastname: Zhang
authors.forename: Yong
authors.initials: Y
authors.lastname: Zhou
authors.forename: Xiao-Ting
authors.initials: XT
authors.lastname: Wu
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D011183:Postoperative Complications / Q000517:prevention & control*; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D058616:Synbiotics