title: Probiotics and Synbiotics Decrease Postoperative Sepsis in Elective Gastrointestinal Surgical Patients: a Meta-Analysis.
abstract: The health benefits of probiotics and synbiotics are well established in healthy adults, but their role in preventing postoperative sepsis remains controversial. This meta-analysis assesses the impact of probiotics and synbiotics on the incidence of postoperative sepsis in gastrointestinal (GI) surgical patients.
  
  
  
  A comprehensive literature search of all published randomized control trials (RCTs) was conducted using PubMed, Cochrane Central Registry of Controlled Trials, and Google Scholar (1966-2015). Inclusion criteria included RCTs comparing the use of any strain or dose of a specified probiotic/synbiotic with placebo or a "no treatment" control group. The incidence of postoperative sepsis (within 1 month of surgery) and postoperative mortality were analyzed.
  
  
  
  Fifteen RCTs involving 1201 patients (192 receiving probiotics, 413 receiving synbiotics, and 596 receiving placebo) were analyzed. Overall, probiotic and synbiotic uses significantly reduced the risk of developing postoperative sepsis by 38 % (relative risk (RR) = 0.62, 95 % confidence interval (CI) 0.52-0.74, p < 0.001).
  
  
  
  The use of probiotic/synbiotic supplementation is associated with a significant reduction in the risk of developing postoperative sepsis in patients undergoing elective GI surgery. Probiotic/synbiotic supplementation is a valuable adjunct in the care of patients undergoing GI surgery. Additional studies are required to determine the optimal dose and strain of probiotic/synbiotic.
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ, 07039, USA.
authors.forename: Sudha
authors.initials: S
authors.lastname: Arumugam
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ, 07039, USA.|Saint George's University School of Medicine, True Blue, Grenada, West Indies.
authors.forename: Christine S M
authors.initials: CS
authors.lastname: Lau
authors.affiliation: Department of Surgery, Saint Barnabas Medical Center, 94 Old Short Hills Road, Livingston, NJ, 07039, USA. rchamberlain@barnabashealth.org.|Department of Surgery, Rutgers University, New Jersey Medical School, Newark, NJ, USA. rchamberlain@barnabashealth.org.|Saint George's University School of Medicine, True Blue, Grenada, West Indies. rchamberlain@barnabashealth.org.
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Chamberlain
mesh_terms: D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D019936:Probiotics / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D018805:Sepsis / Q000453:epidemiology*; D058616:Synbiotics / Q000008:administration & dosage*
keywords: Gastrointestinal surgery; Perioperative mortality; Postoperative sepsis; Probiotic; Synbiotic