Chyme Reinfusion Is Associated with Lower Rate of Postoperative Ileus in Crohn's Disease Patients After Stoma Closure.
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.
['Duan|Ming|M|', 'Cao|Lei|L|', 'Gao|Lei|L|', 'Gong|Jianfeng|J|', 'Li|Yi|Y|', 'Zhu|Weiming|W|']
D000293:Adolescent D000328:Adult D003424:Crohn Disease D016208:Databases, Factual D004750:Enteral Nutrition D005260:Female D006801:Humans D007081:Ileostomy D045823:Ileus D007902:Length of Stay D008297:Male D020127:Recovery of Function D012189:Retrospective Studies D018570:Risk Assessment D012307:Risk Factors D017792:Surgical Stapling D013536:Suture Techniques D013997:Time Factors D016896:Treatment Outcome D055815:Young Adult
Chyme reinfusion Ileus Enterostomy Crohn’s disease