Table 3.

Clinical trials of probiotics interventions for prevention, post-operative complications and treatment of CRC

Type of intervention	Patients	Probiotic strain	Length of treatment	Outcome	Ref
Prevention	38 healthy patients	L. rhamnosus	4 weeks	Reduce of b-glycosidase activity by 10% and urease activity by 13%	(44)
	17 healthy patients	RS vs. BF lactis	4 weeks	Induced unique changes in fecal microflora but did not significantly alter any other fecal, serum, or epithelial variables.	(45)
	10 CRC and 20 healthy patients	L. gasseri (LG21)	12 weeks	A deterioration of the intestinal environment was observed in the colorectal cancer patients in comparison to the healthy controls, and the intestinal environment improved when probiotics was taken.	(46)
Prevention of post-operative complication	100 CRC patients undergoing surgery (placebo group/ probiotics group n=50/50)	L. plantarum L. acidophilus B. longum	16 days	Improvement in the integrity of gut mucosal barrier and decrease in infections complications	(8)
	124 CRC patients undergoing surgery (placebo group/ probiotics group n=80/84)	L. acidophilus L. plantarum B. lactis BB S. boulardii	15 days	Decreased the rate of all postoperative major complication, gene expression of TNF and circulating concentrations of IL-6 were under the control of SOCS3 in the probiotics group	(47)
	156 CRC patients undergoing surgery (placebo group/ probiotics group n=81/75)	E. faecalis C. butyricum B. mesentericus	15 days	Probiotic treatment reduce superficial incisional surgical site infections (SSIs) in patients undergoing CRC surgery	(48)
	60 CRC patients undergoing surgery (placebo group/ probiotics group n=30/30)	B. longum L. acidophilus E. faecalis	12 days	Faster recovery of bowel function, lower incidences of diarrhea, and slightly lower rate of bacteremia.in probiotic group	(49)
Chemotherapy and radiation therapy related toxicity	150 CRC patients undertreated	L. rhamnosus GG	24 weeks	Patients had less diarrhea, less abdominal pain, less hospital care, and had fewer chemo dose reductions due to bowel toxicity	(50)
	490 gynecological cancer and CRC patients	VSL#3 (a mixture of 8 probiotics)	From the 1st day of radiation therapy	Significant decrease of diarrhea (31.6 vs. 51.8%) and Severe diarrhea (1.4 vs. 55.4%)	(51)