Abstract
BackgroundColonic transendoscopic enteral tubing (TET) refers to colonic transendoscopic tube-delivered enteral therapy. Colonic TET has been successfully used for frequent colonic administration of drugs or multiple fecal microbiota transplantations (FMTs). This prospective observational study aimed to evaluate possible factors affecting methodology, feasibility and safety of colonic TET.MethodsPatients who underwent colonic TET at our center from October 2014 to November 2018 were included. The feasibility, efficacy, and safety of TET were evaluated.ResultsIn total, 224 patients were analyzed. The success rate of TET was 100%. The median retention time of TET tube within the colonic lumen was 8.5 (IQR 7–11) days in 158 patients with tube falling out spontaneously, and the maximum retention time was up to 28 days. These patients were divided into the short-retention group (≤ 8.5 days) and the long-retention group (> 8.5 days). Univariate and multivariate analysis demonstrated that the type of endoscopic clip (p = 0.001) was an independent factor for the retention time. The larger clips as well as a greater number of clips significantly affected the retention time (p = 0.013). No severe adverse event was observed during and after TET.ConclusionsColonic TET is a feasible, practical, and safe colon-targeted drug delivery technique with a high degree of patients’ satisfaction. Two to four large endoscopic clips are recommended to maintain stability of the TET tube within the colon for over 7 days.
Highlights
Colonic transendoscopic enteral tubing (TET) refers to colonic transendoscopic tube-delivered enteral therapy
In order to meet the needs of patients with multiple fresh Fecal microbiota transplantation (FMT) or whole colon administration of drugs during a period of time, we developed a colonic delivery method by the long-term maintenance of an indwelling, colonoscopically placed transanal enteral tube, which was coined colonic TET [14]
The most distal loop site on the TET tube relative to the anus was fixed at the ileocecal junction in 192 patients (85.6%), ascending colon in 17 patients (7.6%), transverse colon in 5 patients (2.2%), and descending colon in 6 (2.7%) patients
Summary
Colonic transendoscopic enteral tubing (TET) refers to colonic transendoscopic tube-delivered enteral therapy. Colonic TET has been successfully used for frequent colonic administration of drugs or multiple fecal microbiota transplantations (FMTs). Delivering FMT by colonoscopy is a traditional method, but for patients who need repeated FMTs in a short period of time, they have to endure multiple bowel preparations and colonoscopy. Another way of FMT delivery is by enema, the bacteria can only reach the rectal and sigmoid colon. In order to meet the needs of patients with multiple fresh FMTs or whole colon administration of drugs during a period of time, we developed a colonic delivery method by the long-term maintenance of an indwelling, colonoscopically placed transanal enteral tube, which was coined colonic TET [14]. The technique of placing a tube through the anus into cecum for whole colon administration of FMTs or medications is achieved, and it has been successfully used in many hospitals in Asia in recent 2 years [6, 10, 14, 24, 25]
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