Skip to main content

Table 2 Meta-analyses investigating the role of MBP and OABs in elective colorectal surgery

From: The gut microbiota and colorectal surgery outcomes: facts or hype? A narrative review

Author (year) Sample size Design Groups Outcomes Results Quality assessment/risk of bias
Rollins (2019) [8] Total: 69,517 patients; 28 RCTs with 6437 patients;
12 cohort studies with 63,080 patients
Meta-analysis of RCTs and non-randomized studies 1. MBP + OABs vs MBP
2. MBP + OABs vs OABs
3. MBP + OABs vs no preparation
4. OABs alone versus no preparation
5. OABs vs MBP
SSI, anastomotic leak, 30-day mortality, overall morbidity, development of ileus, reoperation and Cdiff infection 1.—SSIs reduced in the combined and in the RCT analysis
- AL, mortality, morbidity, ileus, reduced in the combined but NS in the RCT analysis
- Cdiff NS
2.—30 days mortality, ileus reduced in the combined but NS in the RCT analysis
- other outcomes NS in the combined and RCT analysis
3. RCTs unavailable
4. RCTs unavailable
5. RCTs unavailable
Variable risk of bias in the RCTs, poor documentation on randomization methods, allocation concealment, and blinding
Heterogeneity due to the different antibiotic regimens
Toh (2018) [9] 38 RCTs with 8458 patients Network meta-analysis of RCTs 1. MBP + OABs vs MBP
2. MBP + OABs vs OABs
3. MBP + OABs vs no preparation (indirect comparison)
4. OABs alone versus no preparation (indirect comparison)
5. MBP vs no preparation
6. OAB vs MBP
Primary: total, incisional, and organ/space SSI
Secondary: anastomotic leak, mortality, readmissions/reoperations, UTI, pulmonary complications
Primary:
1. Reduced total, incisional and organ/space SSIs
2. NS
3. Reduced total SSIs
4. Reduced organ/space SSIs
5. Reduced organ/space SSIs
6. SSIs NS
Secondary: NS for every outcome and every comparison
Variable risk of bias, heterogeneity +  +  + for the different resection sites and antibiotic treatments, no RCTs in every category led to the use of indirect comparisons