EN
TÜRKÇE
Poster - 147
Indications and outcomes of refeeding via mucous fistula in neonates: a retrospective study at a tertiary care center
Ana Gabriela Barría Rodríguez 1, José Andrés Molino Gahete 1, Melissa Fernanda Torres Cordón 1, Sergio López Fernández 1, Marta Martos Rodríguez 1, Karla Estefania Fernández 1, César Ruiz Campillo 2, Gabriela Guillén Burrieza 1
1 Oncologic, Neonatal, and HPB Surgery Unit. Pediatric Surgery Department, Vall d’Hebron University Hospital. Barcelona, Spain.
2 Neonatology Department, Vall d’Hebron University Hospital. Barcelona, Spain.
Purpose
Mucous fistula refeeding (MFR) helps preserve intestinal function in ostomized patients by reinfusing the proximal stoma output into the distal mucous fistula. Our objective was to define the indications, assess the effectiveness, and identify potential complications of MFR during the neonatal period.
Methods
We conducted a retrospective study (2011–2024) of 29 patients who underwent surgery during the neonatal period and received MFR. The indications for MFR were stimulation or decompression of the defunctionalized bowel and/or reduction of total parenteral nutrition (TPN) dependence and its associated complications.
Results
Neonates who received MFR showed a reduction in parenteral nutrition requirements from the start of refeeding to the day before reanastomosis, decreasing from 86.65% to 59.5% in cases of intestinal atresia, from 45.5% to 35.5% in meconium ileus, from 60.5% to 5% in intestinal ischemia, and from 55% to 50% in necrotizing enterocolitis. Full enteral feeding was achieved before reanastomosis in 35% of patients. In those with intestinal atresia, a reduction in the diameter discrepancy between bowel segments was observed. In all cases, bowel transit was restored with stool passage prior to ostomy closure. Three patients required home TPN. The most frequent complications were reflux of intestinal contents (50%) and leakage around the tube (29.4%).
Conclusion
Mucous fistula refeeding promotes intestinal growth and adaptation, can be performed safely, reduces the need for parenteral nutrition, and facilitates decompression and stimulation of the hypoplastic, defunctionalized bowel in cases of meconium ileus and intestinal atresia.