Evidence map›Paper›PMID 40616766›Full record

SynthesisDigestive diseases and sciences2025

Chyme Reinfusion in Patients with High-Output Enterocutaneous Fistulas and Enterostomies Undergoing Surgical Reconstruction: A Systematic Literature Review and Meta-Analysis.

Sascha Vaghiri, Alireza Pandkhahi, Ward Al Akeel, Sultan Kazziha, Ali Alipouriani, Hermann Kessler, Wolfram Trudo Knoefel, Dimitrios Prassas

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Digestive diseases and sciences, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Sascha Vaghiri *Department of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Moorenstr. 5, Bldg. 12.46, 40225, Duesseldorf, Germany.
Alireza Pandkhahi *Medical Research School Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Ward Al AkeelMedical Research School Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Sultan KazzihaMedical Research School Duesseldorf, Heinrich-Heine-University Duesseldorf, Moorenstr. 5, 40225, Duesseldorf, Germany.
Ali AlipourianiDepartment of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Hermann KesslerDepartment of Colorectal Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA.
Wolfram Trudo KnoefelDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Moorenstr. 5, Bldg. 12.46, 40225, Duesseldorf, Germany.
Dimitrios PrassasDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University Hospital Duesseldorf, Moorenstr. 5, Bldg. 12.46, 40225, Duesseldorf, Germany. Dimitrios.Prassas@med.uni-duesseldorf.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChyme reinfusion (CR) is a simple technique that reestablishes gastrointestinal continuity. The primary objective was to analyze the pooled evidence of the CR effect on postoperative outcomes following ostomy or fistula repair.

methodsThis meta-analysis was performed according to the current PRISMA guidelines and included all studies that provided postoperative outcome data on CR compared with the control group (no CR) in high-output ostomies and enterocutaneous fistulas. The data from eligible studies were extracted, qualitatively assessed, and included. Odds ratios (ORs) and standardized mean differences (SMDs) with 95% confidence intervals (CIs) were calculated. The risk of bias was assessed using the ROBINS-I criteria.

resultsFive eligible studies with a total of 460 patients were included (CR: n = 219, control: n = 241). CR demonstrated significantly lower rates of overall complications (OR 0.25, 95% CI 0.13-0.46, p < 0.00001), ileus (OR 0.35, 95% CI 0.22-0.53, p < 0.00001), and diarrhea (OR 0.29, 95% CI 0.12-0.69, p = 0.005). As a result, the hospital stay was significantly reduced after CR as compared to the control group (SMD - 0.76, 95% CI - 1.46 to - 0.07, p = 0.03). In addition, the postoperative inflammatory markers CRP (C-reactive protein) (SMD - 0.76, 95% CI - 0.98 to - 0.53, p < 0.0001) and WBC (white blood count) (SMD - 0.67, 95% CI - 1.09 to - 0.25, p = 0.002) were significantly lower after CR.

conclusionsCR is a safe and easy-to-use method which leads to a significant reduction in inflammatory response and postoperative complications such as ileus or diarrhea and thus significantly shortens the hospital stay. This method should therefore be considered as an additional supportive procedure for patients with high-output ostomies or fistulas. The further legitimacy and justification of CR should now be verified in multi-center randomized studies.

Indexed as

EnterostomyIntestinal FistulaPlastic Surgery ProceduresHumansPostoperative ComplicationsTreatment OutcomeChyme reinfusionEnterocutaneous fistulaHigh-output ostomyPostoperative morbidity

Identifiers

PMID40616766
PMCPMC12531272

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.