Aims: Neonates with small bowel enterostomy face substantial challenges in maintaining fluid balance, optimal nutrition and growth, especially in low- and middle-income countries (LMIC) where parenteral nutrition is not extensively available. Moreover, the discrepancy between proximal and unused distal loop often makes the anastomosis challenging and risky during closure. This study was aimed to describe a simple method of mucous fistula refeeding (MFR) in a resource constrained environment and to see the impact of MFR on growth and nutrition and distal intestine diameter. Methods: A simplified MFR technique requiring minimal resources was employed, which was taught to and carried out by the caregivers. Distal loopogram was performed before commencement of MFR and before stoma closure. The weight gain and width difference of the distal loop at splenic flexure was measured. Statistical analysis was done in SPSS 26.0 and p <0.05 considered to be significant. Results: We implemented MFR on ten consecutive neonates. The indications for enterostomy formation were meconium ileus (6), three among them were complicated, ileal atresia (3), and intestinal perforation (1). Mean rate of weight gain was 18 gm/day and mean gut width increment was 0.1 mm/day (p < 0.05). One patient (10%) had anastomotic leakage following stoma closure. Conclusion: Mucous fistula refeeding is a safe method that can reduce nutritional complications and enhance growth, and reduce bowel lumen discrepancy, making the anastomosis safer during stoma closure.
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Huq et al. (2024) studied this question.