Beneficial Impacts of pre- and Postoperative Probiotics/Synbiotics Supplementation in Patients Undergoing Gastrointestinal Surgeries: An Umbrella Meta-Analysis
Abstract
Probiotics and synbiotics may help reduce complications following gastrointestinal (GI) surgeries by restoring microbial balance and modulating immune responses. This umbrella meta-analysis aimed to evaluate their effectiveness in improving pre- and postoperative outcomes. Following PRISMA guidelines, 17 meta-analyses were included after a comprehensive database search. Outcomes assessed included infection rates, hospital stay, diarrhea, mortality, and antibiotic use. Study quality was evaluated using the AMSTAR 2 tool. Pooled effect sizes were calculated using a random-effects model. Heterogeneity was quantified with the I² statistic and Cochrane’s Q-test, and predefined subgroup analyses were conducted by intervention type, treatment duration, surgical complications, and patient condition. Sensitivity analyses evaluated result stability. Publication bias was assessed using funnel plots, Begg’s and Egger’s tests, with the trim-and-fill method applied where asymmetry was detected. Significantly reduced postoperative infections (OR = 0.48, 95% CI: 0.42–0.53), including surgical site infections, urinary tract infections, pulmonary infections, and sepsis. Supplementation also shortened hospital stays (SMD = − 0.95, 95% CI: − 1.79 to − 0.10), decreased the incidence of diarrhea (OR = 0.37, 95% CI: 0.23–0.50), lowered mortality (OR = 0.48, 95% CI: 0.13–0.82), and reduced antibiotic use duration (SMD = − 1.87, 95% CI: − 3.69 to − 0.05). Preoperative-only supplementation use was…
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