The role of probiotics in modulating complications and intestinal barrier integrity after colorectal cancer…

ReviewGastroenterology and hepatology from bed to bench· 2026

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

Colon & Rectal SurgeryReviewTreatmentQ3IF 1.6

Probiotics after colorectal cancer surgery lowered septicemia risk versus controls.

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 … Amirali Zareie Shab Khaneh

Gastroenterology and hepatology from bed to bench · 2026 · Q3 in Gastroenterology

Background

Postoperative complications pose a substantial challenge in colorectal cancer.

Purpose

This systematic review and meta-analysis evaluated the impact of probiotics on postoperative complications and intestinal barrier integrity markers in patients with colorectal cancer (colorectal cancer) undergoing surgery.

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 (randomized controlled trials) 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]).

n = 1,234 CRC patients

RD=-0.158

Results

RD=-0.158

probiotics lowered patients' risk of developing bloodstream infection after surgery

n = 1,234 CRC patients

More results

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).

More results

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.

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Conclusion

Probiotics reduced the risk of specific infectious and gastrointestinal complications and enhanced intestinal barrier function after colorectal cancer surgery, highlighting their potential as a safe and effective adjunct to improve postoperative outcomes.

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

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

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