Methodology of colonic transendoscopic enteral tubing for ulcerative colitis

Abstract

Objective To evaluate the method of colonic transendoscopic enteral tubing (TET) for ulcerative colitis (UC) as a new colonic interventional delivering in fecal microbiota transplantation (FMT) or medications, and to analyze influencing factors for retention time of TET tube. Methods UC patients who underwent colonic TET for FMT and/or colonic administration in the Second Affiliated Hospital of Nanjing Medical University from October 2015 to March 2019 were prospectively enrolled. The TET method, procedure time, success rate, adverse events and satisfaction degree, retention time of TET tube were recorded and their influencing factors were analyzed. Results A total of 150 UC patients underwent colonic TET. The TET tubes were used in 126 patients (84.0%) for FMT and medication, 18 patients (12.0%) for FMT, and 5 patients (3.3%) for medication. The mean TET procedure time was (9.6 ± 2.7) min. The success rate of TET procedure was 100%. The median retention time of TET tube was 9 (7.0, 11.0) d in 122 patients with the tube falling out naturally. In patients with large endoscopic clips, the retention time of TET tube was significantly prolonged with the increased number of large clips (n=2~4, P=0.002) . The retention time of TET tube in the large clip group was longer than that in the small clip group, when the number of endoscopic clips used was the same (n=3 or 4, P<0.05) . The type (OR=0.085, 95%CI: 0.020 to 0.354, P=0.001) and number (OR=0.509, 95%CI: 0.294 to 0.881, P=0.016) of endoscopic clips were the influencing factors for the retention time of tube. No severe adverse event was observed during and after TET. The satisfaction degree on colonic TET was 96.0% (144/150) in all the patients. Conclusions Colonic TET as a colonic delivering of multiple FMT and frequent colonic medication administration for UC patients is safe and feasible. The retention time of TET tube is related to the type and number of endoscopic clip. Key words: Transendoscopic enteral tubing; Fecal microbiota transplantation; Ulcerative colitis; Colonoscopy; Enema