Greeting.

What is your practice for managing the distal intestinal segment after surgery in a newborn? Especially if the distal segment starts from the colon. Is it through refeeding the stoma output from the proximal segment? Breast milk? Or just providing electrolyte fluids?"

Hello! I do not work in a NICU with surgical patients now but will check the Stockholm practise. Re-feeding the proximal stoma content is the general principle but I think it depends on the level of the stoma (as you suggest). Lets hope more share their feedback!

@Francesco Cardona what is your thoughts with your PICU perspective?

I work in many surgical units and most will refeed. However, this depends on the surgeons and their experience.  While most centres do refeed, a few don’t.

Here’s a link to a review of the available evidence suggesting potential benefits to refeeding rather than withholding it.

https://pubmed.ncbi.nlm.nih.gov/36858828/

The "bypass" technique. Typically, the fluid draining from distal ostoma is diverted through the distal ostoma.

There was decrease in the number of days of parenteral use and improvement of cholestasis