[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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[in Japanese]

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The efficacy of re‐infusion of fluids from the oral side to the anal side of an ostomy was recently described in many reports. We created a new system to infuse fluids automatically from the oral side to the anal side and applied it effectively in 4 cases.
Outline of the system：Drainage fluid is collected in a bottle from the ostomy pouch and a catheter is inserted into the anal side of the ostomy. Fluids are infused automatically through the tube, which continues from the bottom of the bottle to the catheter in the anal side using an enteral nutrition pump. Enteral feeding formula can also be infused simultaneously into the anal side of the ostomy from a T‐sharp stopcock. The amount of liquid in the bottle is sufficiently controlled. Saline can be added in the case of reduced fluid drainage, whereas excess fluid is removed to avoid the proliferation of bacteria.
This system enables continuous infusion easily and stably, and is therefore useful for the re‐infusion of oral side drainage fluid into the anal side of an ostomy.

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 We analyzed 138 patients managed by the nutrition support team (NST) in fiscal 2018 to evaluate the success of NST intervention and its association with poor prognostic factors. We examined the age, sex, disease, number of days between admission and NST intervention, prognostic nutritional index，number of interventions, outcome, and nutrition assessment after the intervention. We also examined the nutrition administration route, dose of energy and protein, weight, and blood examination results before and after the intervention. Intervention significantly improved the dose of energy and protein, serum transthyretin, total cholesterol value, and CRP level. Fifteen patients were assessed as having a“worsened”condition after the intervention, or were dead at the time of discharge. We defined them as the“poor prognosis group”and analyzed the relationship between this group and the factors before the intervention. Multivariate analysis revealed the number of days between admission and NST intervention and serum cholinesterase level before the intervention to be independent prognostic factors. Our study demonstrated that NST intervention at our hospital was partially effective and that the duration and nutritional quality before NST interventions are important for the prognosis．

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Roux stasis syndrome (RSS) , in which gastric emptying is delayed despite no stenosis after distal gastrectomy with Roux‐en‐Y reconstruction (R‐Y) , requires long‐term treatment and consideration of nutritional disorders. We reported three cases of RSS where patients maintained nutritional status using conservative treatment with Kangaroo™ W‐ED Tube (W‐EDT) . Case 1 was a 76‐year‐old woman who underwent gastrectomy with R‐Y and developed RSS 10 days after surgery. Case 2 was a 47‐year‐old man, and case 3 was a 68‐year‐old woman, both of whom developed RSS eight days after surgery. In all cases, the W‐EDT, was placed and gastric decompression and enteral nutrition (EN) were performed. Oral ingestion resumed 21 days, 29 days, and 63 days, respectively, after the onset of RSS. For all of them, the Controlling Nutritional Status score before discharge remained below 2 and no progression of nutritional disorders was observed. W‐EDT was helpful in gastric decompression and maintaining nutritional status using EN for RSS from one nasal cavity, and was considered to be useful for long‐term treatment．

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