Feasibility and Safety of an Automated Chyme Reinfusion System for High-Output Stomas and Enterocutaneous Fistulas
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ID: 315748
2026
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Abstract
Abstract Background Managing of high-output stomas (HOS) and enterocutaneous fistulas (ECF) is complex, involving risks of dehydration, electrolyte imbalances, and malnutrition. While parenteral nutrition (PN) remains the standard of care, it carries significant risks of infectious and metabolic complications. Aims Chyme reinfusion (CR) is recognized as beneficial, but its implementation is often limited by logistical constraints. This study aimed to evaluate feasibility and safety of an automated reinfusion device. Methods We conducted a retrospective, observational, single-center study. Adult patients with HOS or ECF treated with the automated device between January 2022 and December 2025 were included. The system integrates a pump within a standard stoma appliance, magnetically driven by an external controller to allow intermittent CR into the distal bowel. The primary endpoint was technical feasibility, defined as successful use of the device without premature discontinuation due to device failure. Secondary endpoints included complications, changes in PN requirements, and evolution of weight and serum albumin. Results Twelve patients were included. Technical feasibility was achieved in 10 cases. CR was initiated a median of 37 days after initial surgery for a median duration of 33 days. Regarding nutritional support, three patients discontinued PN and three others reduced requirements. Median weight increased from 61.7 kg to 65.3 kg, and median serum albumin from 25 g/L to 30 g/L by the end of treatment. Device-related difficulties were reported in eight patients (67%), mainly mechanical (catheter occlusion or dislodgement). One severe complication occurred (migration) requiring bowel resection. Conclusion Automated CR appears technically feasible in selected patients. Although mechanical complications remain frequent, this device represents a significant advancement in promoting patient autonomy and intestinal rehabilitation. Our findings suggest nutritional benefits and a reduced need for PN. Prospective studies are required to further assess safety, patient selection and clinical outcome.
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| Authors | M Boros, J Saadoun, J Meyer, E Liot, G Meurette, F Ris |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.043
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| URL | |
| Keywords | Keywords not found |
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