P1037 - CHYME REINFUSION WITH THE INSIDES SYSTEMTM INNOVATIVE TOOL IN A COHORT OF PATIENTS WITH HIGH OUTPUT STOMA OR ENTEROCUTANEOUS FISTULA.

P1037

CHYME REINFUSION WITH THE INSIDES SYSTEMTM INNOVATIVE TOOL IN A COHORT OF PATIENTS WITH HIGH OUTPUT STOMA OR ENTEROCUTANEOUS FISTULA.

A. JIRKA^1,*, M. VAROQUI¹, A. DESCHAMPS², E. DUCHALAIS², C. CATHY-LEMOINE²

¹Hepato-gastro-enterology & Nutrition Support, ²Digestive and Oncological Surgery, CHU Nantes, Nantes, France

Rationale: The chyme reinfusion (CR) is a technique used for treatment of intestinal insufficiency, pumping the chyme to an efferent bowel segment. ESPEN Guidelines suggests CR as an alternative option for Intestinal Insufficiency type 2 management.

Methods: This study is a retrospective review of a single cohort of patients operated between 01/2022 and 01/2024. All patients were diagnosed with intestinal insufficiency and required IV support related to high output stoma. They had double stoma with access to afferent and efferent bowel segments. They were in stable condition, hospitalized in standard surgery ward. The study was allowed by the Institutional Review Board for ethical aspects.

Results: A total of 22 successive patients hospitalized for intestinal insufficiency with indication of CR using The Insides System^TM.  Main cause of intestinal insufficiency was SBS type 1 with median stoma output of 2000 [1600-2400] ml/day. Home discharge was possible in 95% patients.  Twenty patients treated with CR were operated for restauration of bowel continuity with a median delay of 97 [65-145] days. Parenteral support was reduced in all patients and stopped in 13 (62%) patients. Weight remained stable and albumin level significantly increased  between CR starting and surgery of bowel continuity.

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Conclusion: In conclusion, The INSIDE System^TM is a safe, efficient tool for the management of instestinal failure type 2 in carefully chosen patients, allowing reduction of IV suppors and home discharge in 95% of patients. More data are required to evaluate the impact on quality of life.

References: Picot D et al. Chyme reinfusion in patients with intestinal failure due to temporary double enterostomy: a 15-year prospective cohort in a referral centre.Clin Nutr 36:593-600.

Sharma P et al.  Novel chyme reinfusion device for gastrointestinal fistulas and stomas: feasibility study.Br J Surg.;107:1199-1210. 

Disclosure of Interest: None declared