WOFAPS 2025 8th World Congress of Pediatric Surgery

Ju Yeon Lee ¹, Chaeyoun Oh ²

¹ Department of Pediatric Surgery, Chonnam National University Hospital, Gwangju, Korea
² Division of Pediatric Surgery, Department of Surgery, Korea University College of Medicine, Korea University Ansan Hospital, Ansan, Korea

Purpose
Refeeding in pediatric patients with a high-output bowel stoma is critical for maintaining intestinal continuity and nutrient absorption. While larger tubes are thought to provide better flow efficiency, they may increase risks such as mucosal injury, perforation, and obstruction, especially with repeated catheterization. This study’s primary aim was to assess if indwelling, smaller-caliber tubes could achieve sufficient flow efficiency in a bench setting. The secondary aim was to examine how tube configuration and infusion rate influence performance.

Method
Nine 3D-printed tubes (5, 7, and 9 mm diameters) with U, straight, or V shapes were tested in a simulated stoma (12.25 mm). A liquid nutritional formula (1000 mL, Newcare) was infused at 100 and 50 cc/hour using a feeding pump. Each model was tested five times. Flow efficiency was defined as the percentage of input volume passing through the tube.

Results
No significant differences in flow efficiency were found between configurations. At 100 cc/hour, 9 mm tubes had the highest efficiency (95.2%), followed by 7 mm (62.5%) and 5 mm (55.5%). At 50 cc/hour, 9 mm tubes again performed best (96.9%), followed by 7 mm (64.7%) and 5 mm (57.9%). Although efficiency improved slightly at lower rates, differences were not significant.

Conclusion
Indwelling smaller-caliber tubes, slightly less than half the lumen diameter, showed stable flow with ~60% efficiency. Combined with strategies like reinfusion of residual output, these systems may offer a safer refeeding approach requiring further study.