Awareness And Application Evaluation Of Colonic TET For Washed Microbiota Transplantation

Part oneBackground: This study aimed to explore the recognition and attitudes of fecal microbiota transplantation(FMT)through colonic transendoscopic enteral tubing(TET)in patients with inflammatory bowel disease(IBD).Methods: An anonymous questionnaire was developed based on our team’s experience in implementing FMT and TET.In this study,IBD patients from the Eastern and Southwestern of China were investigated through an online questionnaire on their awareness and attitudes toward FMT and TET.In addition to patients’ demographic characteristics and disease characteristics,the questionnaire mainly focused on patients’ cognition and acceptance of colonic TET for FMT.Patients who had not undergone FMT were mainly investigated for their cognition and acceptance of FMT and TET.Patients who had experience of FMT,the way they underwent FMT and acceptance of TET were the main interest.This study also analyzed the preference of FMT delivery way in patients and the related factors associated with it.Results: A total of 620 eligible questionnaires were included in the analysis,of which 44.03%(273/620)had ulcerative colitis(UC)and 48.39%(300/620)had Crohn’s disease(CD).The results showed that 17.6%(109/620)of the patients had underwent FMT,while the remaining 82.4%(511/620)patients had not related experience.Among the patients who had not underwent FMT,44.6%(228/511)of the patients did not know that FMT is a therapeutic option in IBD,and 80.6%(412/511)of them did not know the concept of TET.More than half(63.2%,323/511)of the participants stated that they would agree to undergo FMT through TET.Of the patients who underwent FMT via TET [62.4%(68/109)],the majority [95.6%(65/68)]of them were satisfied with TET.Patients who had undergone FMT and TET were more likely to recommend FMT than patients who had not(94.5% vs 86.3%,p =0.018 and 98.5% vs 87.8%,p = 0.017).Patients’ choice for the delivery way of FMT would be affected by the type of disease and whether the patient had the experience of FMT.When compared to patients without experience of FMT,CD and UC patients who had experience of FMT preferred mid-gut TET(p < 0.001)and colonic TET(p <0.001),respectively.Conclusion: Patients’ experience of FMT through TET lead them to maintain a positive attitude towards FMT.The present findings highlighted the significance of patient education on FMT and TET.Part twoBackground: This study is aimed at evaluating the safety,feasibility,and value of colonic transendoscopic enteral tubing(TET)in 3-7 years old children.Methods: All patients aged 3-7 years who underwent colonic TET in our center were included.The success rate of colonic TET,type and number of titanium clips,adverse events,etc.,were recorded.The factors affecting the retention time of colonic TET were also analyzed.A questionnaire was completed by the children’s parents to evaluate the children’s response to the colonic TET as well as the parent’s satisfaction.Results: A total of 47 children aged 3-7 years(mean age 5 years),42 males and5 females were enrolled,of whom 44.68%(21/47)had autism.TET was implemented into the colon of all the patients.The success rate of TET was 100%,with 35 patients using large titanium clips for fixation and the remaining 12 patients using small titanium clips.The median retention time of TET tube within the colon was 6 days in45 patients with tube falling out spontaneously,and the maximum retention time was up to 21 days.Patients were divided into the short-retaining time group(≤6 days)and the long-retaining time group(>6 days),considering 6 days as median retention time.Univariate and multivariate analysis demonstrated endoscopic clip number(p =0.009)was an independent contributing factor for the retaining time.With increase in the number of large clips,the retention time of TET tube was prolonged.No discomfort was reported during injection of the microbiota or medication suspension through the TET tube.During the follow up,no severe adverse events were observed,and four parents(8.51%)complained that the TET tube had a significant impact on their children’s activities during the retention period.All children’s parents were satisfied with TET.Interestingly,the proportion of children’s parents choosing TET as the delivery way of WMT increased from 29.79% before to 70.21% after TET(p <0.001).Conclusion: This study,for the first time,demonstrates that colonic TET is a novel,safe,and convenient colonic delivery way for WMT and medication in children aged 3-7 years.