Effects of Microecological Preparations on Obese Patients after Bariatric Surgery: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included trials.

Study (year, country)	Total patients, (F : M; age, mean)	Type of surgery	Supplement	Study component	Dose, treatment duration	Results
Woodard et al. [28] (2008, USA)	41,; I: (20/2; 41.2); C:(16/3; 48.6)	LRYGB	Probiotics	Lactobacillus (2.4 × 10^8 CFU)	Once a day,; 6 months	⟷QoL; ↑EWL%; ⟷hsCRP; ↑Vitamin B12
Mokhtari and Slizewska [19] (2019, Iran)	46,; I: (23; 32.35); C: (23; 36.95)	OAGB	Synbiotics	Lactobacillus casei (3.5 × 10^9 CFU/g), Lactobacillus rhamnosus (7.5 × 10^8 CFU/g), Streptococcus thermophilus (1 × 10^8 CFU/g), Bifidobacterium breve (1 × 10^10 CFU/g), Lactobacillus acidophilus (1 × 10^9 CFU/g), Bifidobacterium longum (3.5 × 10^9 CFU/g), Lactobacillus bulgaricus (1 × 10^8 CFU/g), and FOS 38.5 mg	Once a day,; 4 months	↑EWL%; ↓TNF-α; ⟷ IL-6, hs-CRP; ⟷Vitamin B12; ↑25(OH)D3
Fernandes et al. [21] (2016, Brazil)	9,; prebiotic group: (2/1; 36.7); synbiotic group: (3; 42.0); C:(3; 32.0)	RYGB	Prebiotics and synbiotics	Prebiotic: FOS 6 g; Synbiotics: FOS and Lactobacillus paracasei(1 × 10^9 CFU), Lactobacillus rhamnosus (1 × 10^9 CFU), Lactobacillus acidophilus (1 × 10^9 CFU), and Bifidobacterium lactis (1 × 10^9 CFU), 6 g	Once a day,; 15 days	⟷EWL%; ⟷ IL-6; TNF-α; CRP
Dagan et al. [20] (2018, Israel)	80,; I: (24/16; 42.1); C:(22/18; 44.2)	LSG	Probiotics	11 different species of bacteria (>5 × 10^9 CFU)	Twice a day, 6 months	⟷QoL; ⟷ EWL%; ⟷CRP; TNF-α; IL-6; IL-10; ↓GI symptoms: Constipation
Fay et al. [22] (2018, USA)	40,; I:(12/6; 52.7); C:(19/3; 44.1)	LSG	Synbiotics	Bacillus coagulans (4.5 × 10^8 CFU) and galactomannans (300 mg)	Once a day,; 3 months	⟷QoL
Chen et al. [25] (2016, China)	53, group A: (14/5, 36.1) group B: (13/5, 34.8); C: (10/6, 34.4)	RYGB,; MGB, and SG	Probiotics	Group A Clostridium butyricum (5 × 10^8 CFU); Group B Bifidobacterium longum (8 × 10^8 CFU)	Twice a day,; 2 weeks	⟷QoL; ↓GI symptoms; Abdominal pain, bloating, and noises; excessive passage of gas; foul smelling flatulence; belching; heartburn

LRYGB, laparoscopic Roux-en-Y gastric bypass; RYGB, Roux-en-Y gastric bypass; LSG, laparoscopic sleeve gastrectomy; SG, sleeve gastrectomy; OAGB, one-anastomosis gastric bypass; MGB, minigastric bypass; I, intervention group; C, control group; CFU, colony-forming units; FOS, fructo-oligosaccharide; GI symptoms, gastrointestinal symptoms; QoL, quality of life; EWL%, percentage of excess weight loss; IL-6, interleukin 6; TNF-α, tumor necrosis factor-α; CRP, C-reactive protein. ⟷ indicates no significant difference between the intervention and control groups during the follow-up period; ↓ indicates significantly lower in the intervention group as compared to that in the control group during the follow-up period; ↑ indicates significantly higher in the intervention group than that in the control group during the follow-up period. ^∗The intervention group data differed significantly from data of the control group in the third month after surgery, but not significantly different during the follow-up period.