Feasibility, acceptability of chyme reinfusion in patients with double 1 ileostomy: Impact on postoperative complications after re-continuity.

BACKGROUND

Patients requiring double ileostomy after small bowel resection are at risk of intestinal failure and prolonged parenteral nutrition (PN). Chyme reinfusion (CR) restores functional digestive continuity and may improve outcomes. Its feasibility and surgical impact in real-life settings remain underexplored.

OBJECTIVES

were to assess the feasibility, acceptability, and clinical impact of CR using the Insides® System.

MATERIALS AND

METHODS

We conducted an observational cohort study including 31 patients with double ileostomy. Patients were classified into three groups: no CR (NCR, n = 11), daytime CR only (RDO, n = 13), and day-and-night CR (RDN, n = 7). Primary outcomes were PN/hydration dependence, hospital readmissions, time to ileostomy closure, and postoperative complications.

RESULTS

CR was feasible in 68% of patients, with an overall acceptability of 87.5%. PN weaning occurred in 50% of RDN patients versus none in NCR (p = 0.018). Hydration discontinuation was achieved in 23% of RDO and 50% of RDN patients, compared with 0% in NCR (p = 0.039). Hospital readmission rates were markedly reduced with CR (10-14% vs. 73%, p = 0.02). The mean time to ileostomy closure was significantly shorter in CR groups (3.4 months RDO; 5.4 months RDN) compared with NCR (8.2 months, p < 0.01). Anastomotic fistulas occurred only in NCR (27%, p = 0.045). Postoperative diarrhea was less frequent and shorter in duration among CR patients, particularly in the RDN group (p = 0.043). In conclusion, this process is feasible, well-tolerated, and associated with enhanced nutritional autonomy, reduced surgical morbidity, and earlier restoration of intestinal continuity. Larger prospective studies are warranted to confirm efficacy and assess cost-effectiveness.