Mucous fistula refeeding in neonates: a systematic review and meta-analysis
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Read the article on pubmed.ncbi.nlm.nih.gov ↗Article · Jun 2023 · 1 min read
In brief
In brief
This systematic review of 16 observational studies (n=623) found that mucous fistula refeeding—introducing proximal ostomy effluent into the distal limb—reduced parenteral nutrition duration by 37 days in neonates post-abdominal surgery. MFR was also associated with lower cholestasis rates and shorter hospital stays, though evidence certainty remains low pending randomized trials.
Written by the GCMD Library team from the article.
Background and objective: Mucous fistula refeeding (MFR) aims to maximise bowel function when an ostomy is active after abdominal surgery, by introducing the proximal ostomy effluent into the distal mucous fistula to maintain intestinal physiology. The aim of the study was to assess the effectiveness and complications of MFR in neonates following abdominal surgery.
Design, setting and interventions: Systematic review and meta-analysis of randomised controlled trials and observational studies. PubMed, Embase, Cochrane and CINAHL were searched until June 2022 for studies including neonates with ostomy receiving MFR compared with neonates with ostomy without MFR.
Outcomes: The primary outcome was duration of parenteral nutrition. Secondary outcomes were time to full enteral feeds, rates of cholestasis, peak total serum bilirubin, sepsis, time to reanastomosis and length of hospital stay.
Results: A total of 16 observational studies were included (n=623). Compared with comparator group, neonates who received MFR had fewer days of parenteral nutrition (mean difference 37.17 days, 95% CI -63.91 to -10.4, n=244, 5 studies, GRADE: low). In addition, neonates who received MFR had lower rates of cholestasis, shorter time to reach full feeds and shorter hospital stay.
Conclusion: Low certainty of evidence suggests that MFR is associated with shorter duration of parenteral nutrition in neonates following abdominal surgery and stoma creation. Results of ongoing and future randomised trials may help to corroborate these findings.
DOI: 10.1136/archdischild-2022-324995