title: Mucous fistula refeeding in neonates with enterostomies.
abstract: OBJECTIVE
  Neonates with intestinal pathology may require staged surgery with creation of an enterostomy and mucous fistula (MF). Refeeding (MFR) of ostomy output may minimize fluid and electrolyte losses and reduce dependence on parenteral nutrition (PN), though a paucity of evidence exists to support this practice. The purpose of this study was to assess the outcomes of infants undergoing MFR and document associated complications.
  
  
  METHODS
  With REB approval, infants with intestinal failure undergoing MFR between January 2000 and December 2012 were identified. A chart review was conducted and relevant data were collected. Descriptive statistics were used.
  
  
  RESULTS
  Twenty-three neonates underwent MFR. Mean gestational age and birth weight were 35weeks and 2416grams. Pathologies included intestinal atresia (n=12), necrotizing enterocolitis (n=5), meconium ileus (n=4), and other (n=6). Seven patients were able to wean from PN. Four patients had complications: 3 had perforation of the MF, 1 had bleeding. Four patients died, with one death directly attributable to MFR.
  
  
  CONCLUSIONS
  In this cohort MF refeeding was associated with significant complications and ongoing PN dependence. With advances in intestinal rehabilitation and PN, the benefit of MF refeeding must be weighed against the potential complications.
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Candace A
authors.initials: CA
authors.lastname: Haddock
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Jennifer D
authors.initials: JD
authors.lastname: Stanger
authors.affiliation: Division of Neonatology, Department of Pediatrics, British Columbia Children's Hospital, University of British Columbia, and Children's and Women's Health Centre of British Columbia Division of Neonatology, Vancouver, BC, Canada.
authors.forename: Susan G
authors.initials: SG
authors.lastname: Albersheim
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Complex Feeding and Nutrition Service, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Casey
authors.affiliation: Division of Pediatric Surgery, Department of Surgery, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC, Canada. Electronic address: sbutterworth@cw.bc.ca.
authors.forename: Sonia A
authors.initials: SA
authors.lastname: Butterworth
mesh_terms: D001724:Birth Weight; D020345:Enterocolitis, Necrotizing / Q000601:surgery*; D004766:Enterostomy / Q000379:methods*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000601:surgery*; D008297:Male; D010289:Parenteral Nutrition, Total / Q000379:methods*; D016896:Treatment Outcome
keywords: Complications; Fistula; Mucous; Neonates; Refeeding