Evidence map›Paper›PMID 42535221›Full record

ReviewGastroenterology and hepatology from bed to bench2026

The role of probiotics in modulating complications and intestinal barrier integrity after colorectal cancer surgery: a systematic review and meta-analysis of clinical trials.

Armaghan Kiarsi, Mohammadreza Salehi, Melika Jameie, Amirali Zareie Shab Khaneh

Abstract readReview
In one paragraph

Review in Gastroenterology and hepatology from bed to bench, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Armaghan KiarsiFaculty of Health, Medicine and Society (Oncology), University of Chester, Chester, United Kingdom.
Mohammadreza SalehiDepartment of Computer Engineering, Faculty of Engineering, Azad University, Shiraz Branch, Shiraz, Iran.
Melika JameieNeuroscience Research Center, Iran University of Medical Sciences, Tehran, Iran.
Amirali Zareie Shab KhanehAllergy and Lung Health Unit, Centre for Epidemiology and Biostatistics, School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Aim: This systematic review and meta-analysis evaluated the impact of probiotics on postoperative complications and intestinal barrier integrity markers in patients with colorectal cancer (CRC) undergoing surgery. Background: Postoperative complications pose a substantial challenge in CRC. Probiotics have been shown to alleviate these complications through various mechanisms, including improving intestinal barrier integrity. Methods: Following PRISMA guidelines, a systematic search was conducted in MEDLINE, Web of Science, Cochrane Library, and Scopus up to February 1, 2026, to identify randomized controlled trials (RCTs) investigating the effects of probiotics on post-surgical complications, recovery parameters, and functional intestinal barrier biomarkers (lactulose/mannitol [L/M] ratio and transepithelial electrical resistance [TER]). Statistical analysis was performed using random-effects models in R. Effect sizes were expressed as risk differences (RD) for binary outcomes and standardized mean differences (SMD) for continuous outcomes. Heterogeneity was assessed using Cochran's Q and I² statistics (PROSPERO: CRD420251172153). Results: Eleven RCTs involving 1,234 CRC patients were included. Probiotic supplementation significantly reduced the risk of septicemia (RD=-0.158, p=0.029), surgical site infection (RD=-0.060, p=0.024), respiratory tract infection (RD=-0.079, p<0.001), central line infection (RD=-0.096, p=0.007), diarrhea (RD=-0.137, p=0.005), and abdominal distension (RD=-0.172, p=0.005). Functional intestinal barrier markers were significantly improved, evidenced by a decreased L/M ratio (SMD=-1.78, p=0.018) and increased TER (SMD=1.10, p<0.001). Furthermore, the duration of postoperative antibiotic use was significantly shortened (SMD=-0.45, p=0.001). No significant differences were observed for bacteremia, abscess, urinary infection, ileus, anastomotic leak, pyrexia, or hospital stay (p>0.05). Sensitivity analyses showed outcome variability, and substantial heterogeneity existed for pyrexia, septicemia, ileus, and the L/M ratio. Conclusion: Probiotics reduced the risk of specific infectious and gastrointestinal complications and enhanced intestinal barrier function after CRC surgery, highlighting their potential as a safe and effective adjunct to improve postoperative outcomes.

Indexed as

Colorectal neoplasmsDysbiosisIntestinal barrier functionMicrobiotaPostoperative complicationsProbiotics

Identifiers

PMID42535221
PMCPMC13423324

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.