Safety of mucous fistula refeeding in neonates with functional short bowel syndrome: A retrospective review
jpedsurg.org shows its articles on its own site.
Read the article on jpedsurg.org ↗Article · Feb 2019 · 1 min read
In brief
In brief
Retrospective NICU study (2009-2015) of 31 neonates demonstrates that mucous fistula refeeding of proximal stoma effluent is safe, with no major complications and average weight gain of 25.7g/day over 41 days. The technique shows promise for reducing TPN dependence and preventing distal bowel atrophy in functional short bowel syndrome.
Written by the GCMD Library team from the article.
Purpose
Mucous fistula (MF) refeeding of proximal stoma effluent in neonates after small bowel resection can promote nutrient absorption and prevent atrophy of the unused distal bowel. This study aimed to assess the safety of this practice in neonates.
Methods
A retrospective chart review of all patients admitted to the neonatal intensive care unit (NICU) between 2009 and 2015 who underwent a laparotomy with creation of an enterostomy and mucous fistula was performed. Patients were included if they were refed proximal stoma effluent into the MF.
Results
Thirty-one patients were identified that were refed. There were no major complications (perforation, stricture, death) related to refeeding. Patients were refed for an average of 41 days (± 22), with patients gaining an average of 25.7 g/day (± 10.1) while being refed. Total parental nutrition (TPN) was administered for an average of 55 days (± 31.4) between resection and reanastomosis, with only 7 (23%) developing cholestasis and 15 (48%) reaching full feeds in this time. Mean time to full feeds after reanastomosis was 36 days (± 58.6) with two patients having anastomotic leaks.
Conclusion
MF refeeding is a safe technique that has the potential to contribute to significant weight gain and a decreased dependence on total parenteral nutrition.
Level of evidence
II