Colonic transendoscopic enteral tubing: A novel way of transplanting fecal microbiota

Abstract

Background and study aims: Placement of a tube through the anus into the cecum has not yet been established as a method of administering whole-colonic treatment. The aim of this study was to evaluate the safety, feasibility, and value of transendoscopic enteral tubing (TET) for fecal microbiota transplantation (FMT) through the colon. Patients and methods: A prospective observational study was performed of FMT using a new colonic TET technique. Under endoscopic guidance, a TET tube was affixed to the cecum with clips. The safety, value, and satisfaction with the FMT by TET were evaluated. Results: A total of 54 patients underwent TET. The success rate of the TET procedure was 100 % (54/54). Duration of the TET procedures was 14.8 ± 5.8 min. During the TET tube retention period, 98.1 % (53/54) of patients were satisfied with TET. The retention time for whole-colon delivery of the fecal microbiota suspension was 12.4 ± 2.3 days. In 88.4 % (49/54) of cases, no discomfort was reported during injection through the TET tube of the microbiota suspension. No adverse events were see in patients who required tube extubation after FMT. Conclusions: Colonic TET is a novel, safe, convenient, and reliable procedure for FMT that results in a high degree of patient satisfaction.

Clinical efficacy maintains patients’ positive attitudes toward fecal microbiota transplantation

“…Some of these investigated patients underwent FMT through TET technique, because the survey results may change since they experienced TET as colonic delivering way of FMT. [28] Additionally, this study only indicated the current attitudes of patients on FMT. With the improvement of human understanding on FMT, the patients’ attitudes may change in the future.…”

“…[12] On the contrary, none refused to accept the second FMT for the reason of poor aesthetics in this study. In our center, we performed FMT through mid-gut or colonic transendoscopic enteral tubing (TET), [28] which may improve the understanding of FMT and eliminate patients’ concerns about the aesthetics of FMT. It was expected that patients who were unwilling to receive the second FMT would also refuse recommending FMT to other patients.…”

Fecal microbiota transplantation as a method to treat complications after hematopoietic stem cell transplantation

“…The delivery technologies evolve continuously, aiming at both improving efficiency and increasing patient comfort. E.g., transendoscopic delivery to the cecum with pin-assisted tube fixation, and use of oral capsules are the most promising procedures now [19]. Another important question is the necessity of anesthesia upon delivery of donor's transplant.…”

Fecal microbiota transplant – a new frontier in inflammatory bowel disease

“…Less invasive methods, such as retention enema and nasointestinal infusion, may be safer in patients who are frail or severely ill at the time of FMT. Transendoscopic enteral tubing for FMT through the colon has been reported by Peng et al40 Other methods of delivery through small intestine stoma or percutaneous endoscopic gastrojejunostomy have also been reported 40,41…”