{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T17:07:03Z","timestamp":1793725623143,"version":"4.6.1"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T00:00:00Z","timestamp":1778198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Postoperative infections remain a major cause of morbidity and mortality following gastrointestinal surgery. This meta-analysis aims to evaluate the efficacy of perioperative probiotic use in reducing postoperative infections (POI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Eight randomized controlled trials (RCTs) with 755 participants were included. The effect size was calculated as the Odds Ratio (OR) and Risk Ratio (RR) using a random-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The pooled analysis suggested a potential benefit in reducing overall postoperative infections [OR: 0.57 (95% CI: 0.32\u20131.01);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.057] and wound infection [OR: 0.61 (95% CI: 0.35\u20131.06);\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.073]. While the overall effect narrowly missed statistical significance, subgroup analysis revealed a statistically significant reduction in POI when multi-strain\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      and\n                      <jats:italic>Bifidobacterium<\/jats:italic>\n                      formulations were used [RR: 0.64 (95% CI: 0.49\u20130.83)]. The absolute risk reduction (ARR) for this multi-strain subgroup was 13.5%, corresponding to a highly favorable number needed to treat (NNT) of 7.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The current evidence regarding the overall efficacy of perioperative probiotics in decreasing postoperative infectious complications narrowly misses statistical significance. However, the targeted use of multi-strain\n                      <jats:italic>Lactobacillus<\/jats:italic>\n                      and\n                      <jats:italic>Bifidobacterium<\/jats:italic>\n                      formulations significantly reduces the risk of infectious complications. These specific regimens offer a clinically meaningful benefit and support its inclusion in Enhanced Recovery After Surgery (ERAS) protocols for patients undergoing major gastrointestinal surgery.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1746191","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T05:55:27Z","timestamp":1778219727000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Meta-analysis of efficacy of probiotics in reducing postoperative infections and improving outcomes in gastrointestinal surgery"],"prefix":"10.3389","volume":"13","author":[{"given":"Muhammad","family":"Shamim","sequence":"first","affiliation":[{"name":"Department of Surgery, College of Medicine, Prince Sattam bin Abdulaziz University","place":["Alkharj, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"6029075","DOI":"10.1155\/2017\/6029075","article-title":"Probiotics reduce postoperative infections in patients undergoing colorectal surgery: a systematic review and meta-analysis","volume":"2017","author":"Liu","year":"2017","journal-title":"Gastroenterol Res Pract"},{"key":"B2","doi-asserted-by":"publisher","first-page":"556","DOI":"10.3390\/jcm7120556","article-title":"A systematic review, meta-analysis, and meta-regression evaluating the efficacy and mechanisms of action of probiotics and synbiotics in the prevention of surgical site infections and surgery-related complications","volume":"7","author":"Skonieczna-\u017bydecka","year":"2018","journal-title":"J Clin Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1415357","DOI":"10.3389\/fsurg.2024.1415357","article-title":"Meta-analysis of postoperative incision infection risk factors in colorectal cancer surgery","volume":"11","author":"Jia","year":"2024","journal-title":"Front. 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