A randomized multicenter open-label controlled trial to show that mucous fistula refeeding reduces the time from enterostomy closure to full enteral feeds (MUCous FIstula REfeeding ("MUC-FIRE") trial)

儿童的肠造口可能有不同的原因。在肠造口术期间，由于肠的远端部分(肠造口术后的部分)不参与粪便的循环，所以常规的粪便转移被中断。因此，它不利于肠内容物的吸收。因此，这些儿童需要额外的肠外营养。由于肠外营养的不良反应，所有患者都应尽快恢复肠内营养。因此，由于病例报告和回顾分析显示并发症发生率低，术后体重增加更快，世界各地的许多儿科外科中心在肠造口术后常规地对以前未使用的肠道进行粘液瘘管再喂养(MFR)。然而，一些提供者回避这种方法，因为到目前为止，仍然没有高质量的证据证明这种治疗的好处。病例报告和回顾分析显示，并发症发生率低，术后体重增加快。这项研究的目的是在一项随机的前瞻性试验中评估粘膜瘘再喂养的效果。我们假设，与标准护理相比，在肠造口建立和肠造口关闭之间的MFR缩短了肠造口闭合后达到完全肠道喂养的时间。此外，肠外营养的副作用可以减少，缩短婴儿造口术后的住院护理时间。

Enterostomies in children may be created for different reasons. During the presence of an enterostomy the regular stool transfer is interrupted as the distal part of the bowel (the part following the enterostomy) does not participate in the circulation of stool. Therefore it does not contribute to the resorption of enteral contents. As a consequence these children need additional partenteral nutrition. Due to the negative side-effects of parenteral nutrition all patients should return to enteral nutrition as soon as possible. Consequently, many pediatric surgical centers worldwide routinely perform mucous fistula refeeding (MFR) into the former unused bowel after enterostomy creation because case reports and retrospective analyses show low complication rates and faster postoperative weight gain. Several providers, however, shy away from this approach because to date there is still no high quality evidence for the benefit of this treatment. Case reports and retrospective analyses show low complication rates and faster postoperative weight gain. The aim of this study is to assess the effects of mucous fistula refeeding in a randomized, prospective trial. We hypothesize that MFR between enterostomy creation and enterostomy closure reduces the time to full enteral feeds after enterostomy closure compared to standard of care. Moreover, the side effects of parenteral nutrition may be reduced and the postoperative hospital care of infants undergoing ostomy closure shortened.