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Chyme Reinfusion Is Associated with Lower Rate of Postoperative Ileus in Crohn’s Disease Patients After Stoma Closure

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Abstract

Background

The rate of postoperative ileus following stoma closure is high in patients with Crohn’s disease and temporary enterostomy.

Aims

To evaluate the effect of chyme reinfusion on postoperative outcomes including ileus in these patients.

Methods

Patients were screened from January 2012 to December 2017 and divided into chyme reinfusion group (n = 33) and non-chyme reinfusion group (n = 84). The following 30-day postoperative outcomes were evaluated. Univariate and multivariate analyses and propensity score matching were performed to identify risk factors for these postoperative outcomes.

Results

The incidence of postoperative ileus was significantly lower in the chyme reinfusion than in non-chyme reinfusion group, which had been confirmed by the results after matching (3/26 vs 11/26, p = 0.012). The rate of postoperative diarrhea was significantly lower in the chyme reinfusion group compared with non-chyme reinfusion group, whereas the difference was not significant after matching (2/26 vs 6/26, p = 0.191). Additionally, the postoperative length of stay was significantly shorter in the chyme reinfusion than in non-chyme reinfusion group before and after propensity score matching. In the multivariate analysis, chyme reinfusion was an independent protective factor for postoperative ileus (odds ratio 0.218; 95% confidence interval 0.05–0.95; p = 0.042) and for postoperative length of stay (coefficient − 0.191; 95% confidence interval − 0.350 to − 0.032, p = 0.019).

Conclusions

Chyme reinfusion was associated with lower rate of postoperative ileus and shorter length of stay following stoma closure in Crohn’s patients with temporary ileostomy. Further randomized clinical trial between patients with or without chyme reinfusion was needed to confirm these conclusions.

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Acknowledgment

Yi Li and Weiming Zhu conceived and designed the study, acquisition, and interpretation of data and were involved in drafting of the manuscript; Yi Li and Jianfeng Gong were involved acquisition and interpretation of data; Ming Duan and Lei Gao were involved in acquisition and statistical analysis of data; Ming Duan and Lei Cao were involved in interpretation of data for the work, and critical revision of the manuscript for important intellectual content. All authors agree the final approval of the version to be published.

Funding

This work was partly supported by National Natural Science Foundation of China (Grant Nos. 81670471 and 81570500) and Jiangsu Provincial Medical Youth Talent (QNRC2016900, to Yi Li).

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Authors and Affiliations

  1. Jinling Hospital Research Institute General Surgery, Nanjing University, School of Medicine, No. 305 East Zhongshan Road, Nanjing, 210002, China

    Ming Duan, Lei Cao, Lei Gao, Jianfeng Gong, Yi Li & Weiming Zhu

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  1. Ming Duan
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  2. Lei Cao
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Duan, M., Cao, L., Gao, L. et al. Chyme Reinfusion Is Associated with Lower Rate of Postoperative Ileus in Crohn’s Disease Patients After Stoma Closure. Dig Dis Sci 65, 243–249 (2020). https://doi.org/10.1007/s10620-019-05753-w

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  • DOI: https://doi.org/10.1007/s10620-019-05753-w

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