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Updated: Sep 17, 2025

Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Do Perioperative Probiotics/Synbiotics Reduce Postoperative Infection Rates Following Elective Colorectal Surgery? A
Claudia Paterson1, Amanda Nikolic2, Tamara Glyn3
1Department of Surgery, Te Whatu Ora-Counties Manukau, University of Auckland, Auckland, New Zealand.
Introduction:
Postoperative infections remain common in elective colorectal surgery (CRS). Perioperative probiotics/synbiotics have been investigated as a strategy to optimize the intestinal microbiota and reduce postoperative infections. The aim of this study was to conduct an updated systematic review and meta-analysis on the efficacy of perioperative probiotics/synbiotics on postoperative infection rates following elective CRS.
Methods:
Six databases were searched on February 7, 2023, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 guidelines (International Prospective Register of Systematic Reviews: CRD420233392754).
Inclusion Criteria:
randomized controlled trials comparing perioperative probiotics or synbiotics in colorectal resection for malignant or benign disease in patients > 18 y, reporting data on infectious complications within 30 d of surgery.
Exclusion Criteria:
patients undergoing acute colorectal resection, nonrandomized controlled trials, prebiotics alone used as the intervention or control. The primary outcome measure was total postoperative infection rates within 30 d of elective CRS.
Results:
Twenty-eight randomized controlled trials involving 2686 participants demonstrated an association between probiotics/synbiotics and reduced rates of total postoperative infections within 30 d of elective CRS (relative risk 0.55, 95% confidence interval 0.41-0.74, P < 0.001).
Conclusions:
Perioperative probiotics/synbiotics are associated with almost halved total postoperative infection rates within 30 d of elective CRS. Further investigation into optimal regimens and the confounding effect of modern colorectal surgical practice is essential prior to implementation into clinical practice.
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