Background: Gastrointestinal surgery in children and neonates carries high risks of postoperative infections, inflammation, and delayed recovery. Probiotics may help restore gut microbial balance and improve clinical outcomes. This study systematically evaluates the effects of probiotic supplementation on postoperative outcomes in pediatric and neonatal gastrointestinal surgery. Methods: A systematic review and meta-analysis was conducted following Cochrane and PRISMA guidelines. PubMed, Scopus, Cochrane, and Web of Science were searched for randomized controlled trials (RCTs) and observational studies comparing probiotics with placebo, standard care, or surgery alone in children and neonates. Meta-analyses were performed using R programming, with pooled effect estimates reported alongside 95% confidence intervals (CI) and corresponding p-values. Results: Eight studies (6 RCTs and two cohorts) with 437 patients were included. Probiotics significantly reduced postoperative infections (risk ratio = 0.49, 95% CI: 0.26–0.92, p = 0.027) and C-reactive protein elevation (risk ratio = 0.42, 95% CI: 0.26–0.68, p < 0.001) and increased Bifidobacterium abundance (standardized mean difference = 0.84, 95% CI: 0.51–1.17, p < 0.001). No significant effect was seen on hospital length of stay or Lactobacillus concentrations. Qualitative synthesis indicated improvements in bowel function, immune markers, and growth in selected neonatal populations. Conclusions: Probiotics, particularly Bifidobacterium species, may reduce postoperative infections and inflammation in pediatric gastrointestinal surgery; however, the evidence is based on a limited number of studies and small pooled analyses, and larger well-designed trials are needed to confirm these findings.
Alansari et al. (Tue,) studied this question.