{"id":{"repo_id":"auckland-ms","oai_identifier":"oai:researchspace.auckland.ac.nz:2292/73819"},"canonical_url":"https://search.dev.ndltd.org/etd/auckland-ms/oai:researchspace.auckland.ac.nz:2292/73819","repository":{"repo_id":"auckland-ms","name":"University of Auckland","base_url":"https://researchspace.auckland.ac.nz/server/oai/request"},"display":{"title":"Studies of Loop Ileostomy Morbidity and the Potential Benefits of Chyme Reinfusion","abstract":"INTRODUCTION: Loop ileostomy formation is a commonly performed surgical procedure associated with significant morbidity. The objectives of this thesis are to improve the understanding of the risk factors associated with dehydration readmissions following ileostomy formation and assess the impact of chyme reinfusion on clinical, histological and motility outcomes before and after stoma reversal in loop ileostomy patients. METHODS: A meta-analysis pooled clinical risk factors associated with readmissions with dehydration following ileostomy formation. A retrospective cohort study evaluated the incidence and significant risk factors associated with such readmissions in a New Zealand centre. A feasibility study involving a chyme reinfusion device collected patient feedback to inform device development and study protocol for a larger trial. A randomised controlled trial using this device assessed its impact on clinical outcomes prior to and following loop ileostomy reversal. A histology sub-study investigated chyme reinfusion’s impact on terminal ileal and rectal inflammation. A systematic review synthesized the extant understanding of terminal ileal motility as assessed by manometry. A manometry sub-study investigated the impact of chyme reinfusion on terminal ileal motility. RESULTS: Eight clinical variables were significantly associated with dehydration-related readmissions after ileostomy formation. High rates of unplanned readmissions following ileostomy formation was found in the local cohort with similar significant risk factors. The novel chyme reinfusion device was found to be acceptable and feasible in ileostomates. However, in the randomised trial, chyme reinfusion using this device did not lead to any significant differences in pre-operative or post-operative clinical outcomes nor in histological outcomes following ileostomy reversal. Terminal ileal manometry research demonstrated large variability in definitions of motility patterns and pattern characteristics. Some potentially significant differences in terminal ileal motility patterns were seen but these were inconclusive due to the small sample size. CONCLUSIONS: Several ileostomy patient groups are at high risk of readmissions with dehydration and this is a significant local population issue; use of the novel chyme reinfusion device did not lead to any significant improvements in pre-operative clinical, histological or motility outcomes, nor in post-operative recovery following ileostomy reversal and the current understanding of terminal ileal motility is limited with contradictory findings.","abstract_html":"INTRODUCTION: Loop ileostomy formation is a commonly performed surgical procedure associated with significant morbidity. The objectives of this thesis are to improve the understanding of the risk factors associated with dehydration readmissions following ileostomy formation and assess the impact of chyme reinfusion on clinical, histological and motility outcomes before and after stoma reversal in loop ileostomy patients. METHODS: A meta-analysis pooled clinical risk factors associated with readmissions with dehydration following ileostomy formation. A retrospective cohort study evaluated the incidence and significant risk factors associated with such readmissions in a New Zealand centre. A feasibility study involving a chyme reinfusion device collected patient feedback to inform device development and study protocol for a larger trial. A randomised controlled trial using this device assessed its impact on clinical outcomes prior to and following loop ileostomy reversal. A histology sub-study investigated chyme reinfusion’s impact on terminal ileal and rectal inflammation. A systematic review synthesized the extant understanding of terminal ileal motility as assessed by manometry. A manometry sub-study investigated the impact of chyme reinfusion on terminal ileal motility. RESULTS: Eight clinical variables were significantly associated with dehydration-related readmissions after ileostomy formation. High rates of unplanned readmissions following ileostomy formation was found in the local cohort with similar significant risk factors. The novel chyme reinfusion device was found to be acceptable and feasible in ileostomates. However, in the randomised trial, chyme reinfusion using this device did not lead to any significant differences in pre-operative or post-operative clinical outcomes nor in histological outcomes following ileostomy reversal. Terminal ileal manometry research demonstrated large variability in definitions of motility patterns and pattern characteristics. Some potentially significant differences in terminal ileal motility patterns were seen but these were inconclusive due to the small sample size. CONCLUSIONS: Several ileostomy patient groups are at high risk of readmissions with dehydration and this is a significant local population issue; use of the novel chyme reinfusion device did not lead to any significant improvements in pre-operative clinical, histological or motility outcomes, nor in post-operative recovery following ileostomy reversal and the current understanding of terminal ileal motility is limited with contradictory findings.","abstract_has_math":false,"creators":["Liu, Chen"],"institution":"ResearchSpace@Auckland","degree_name":"PhD","degree_level":"Doctoral","degree_discipline":"Surgery","degree_department":null,"school":null,"contributors":[],"advisors":["Bissett, Ian","O’Grady, Greg"],"committee_chairs":[],"committee_members":[],"year":2025,"date_issued":"2025-10-13","date_published":"2025-10-13","updated_at":"2026-07-24T01:06:10Z","subjects":["Colorectal Surgery","Ileostomy","Medical Device","Chyme Reinfusion","Dehydration"],"languages":[],"rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"rights_urls":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"identifier_entries":[]},"links":{"outbound_url":"https://hdl.handle.net/2292/73819","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Bissett, Ian","O’Grady, Greg"]},{"key":"dc:creator","label":"Author","values":["Liu, Chen"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2025-10-21T19:08:06Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2025-10-21T19:08:06Z"]},{"key":"dc:date.issued","label":"Date","values":["2025-10-13"]},{"key":"dc:publisher","label":"Institution","values":["ResearchSpace@Auckland"]},{"key":"dc:type","label":"Dc Type","values":["Thesis"]},{"key":"thesis:degree_discipline","label":"Discipline","values":["Surgery"]},{"key":"thesis:degree_level","label":"Degree Level","values":["Doctoral"]},{"key":"thesis:degree_name","label":"Degree Name","values":["PhD"]},{"key":"thesis:institution_name","label":"Thesis Institution Name","values":["The University of Auckland"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Colorectal Surgery","Ileostomy","Medical Device","Chyme Reinfusion","Dehydration"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:rights","label":"Dc Rights","values":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."]},{"key":"dc:rights.uri","label":"Rights URI","values":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["https://hdl.handle.net/2292/73819"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["INTRODUCTION: Loop ileostomy formation is a commonly performed surgical procedure associated with significant morbidity. The objectives of this thesis are to improve the understanding of the risk factors associated with dehydration readmissions following ileostomy formation and assess the impact of chyme reinfusion on clinical, histological and motility outcomes before and after stoma reversal in loop ileostomy patients. METHODS: A meta-analysis pooled clinical risk factors associated with readmissions with dehydration following ileostomy formation. A retrospective cohort study evaluated the incidence and significant risk factors associated with such readmissions in a New Zealand centre. A feasibility study involving a chyme reinfusion device collected patient feedback to inform device development and study protocol for a larger trial. A randomised controlled trial using this device assessed its impact on clinical outcomes prior to and following loop ileostomy reversal. A histology sub-study investigated chyme reinfusion’s impact on terminal ileal and rectal inflammation. A systematic review synthesized the extant understanding of terminal ileal motility as assessed by manometry. A manometry sub-study investigated the impact of chyme reinfusion on terminal ileal motility. RESULTS: Eight clinical variables were significantly associated with dehydration-related readmissions after ileostomy formation. High rates of unplanned readmissions following ileostomy formation was found in the local cohort with similar significant risk factors. The novel chyme reinfusion device was found to be acceptable and feasible in ileostomates. However, in the randomised trial, chyme reinfusion using this device did not lead to any significant differences in pre-operative or post-operative clinical outcomes nor in histological outcomes following ileostomy reversal. Terminal ileal manometry research demonstrated large variability in definitions of motility patterns and pattern characteristics. Some potentially significant differences in terminal ileal motility patterns were seen but these were inconclusive due to the small sample size. CONCLUSIONS: Several ileostomy patient groups are at high risk of readmissions with dehydration and this is a significant local population issue; use of the novel chyme reinfusion device did not lead to any significant improvements in pre-operative clinical, histological or motility outcomes, nor in post-operative recovery following ileostomy reversal and the current understanding of terminal ileal motility is limited with contradictory findings."]},{"key":"dc:title","label":"Title","values":["Studies of Loop Ileostomy Morbidity and the Potential Benefits of Chyme Reinfusion"]}]}],"canonical_facts":{"dc:contributor.advisor":["Bissett, Ian","O’Grady, Greg"],"dc:creator":["Liu, Chen"],"dc:date.accessioned":["2025-10-21T19:08:06Z"],"dc:date.available":["2025-10-21T19:08:06Z"],"dc:date.issued":["2025-10-13"],"dc:description.abstract":["INTRODUCTION: Loop ileostomy formation is a commonly performed surgical procedure associated with significant morbidity. The objectives of this thesis are to improve the understanding of the risk factors associated with dehydration readmissions following ileostomy formation and assess the impact of chyme reinfusion on clinical, histological and motility outcomes before and after stoma reversal in loop ileostomy patients. METHODS: A meta-analysis pooled clinical risk factors associated with readmissions with dehydration following ileostomy formation. A retrospective cohort study evaluated the incidence and significant risk factors associated with such readmissions in a New Zealand centre. A feasibility study involving a chyme reinfusion device collected patient feedback to inform device development and study protocol for a larger trial. A randomised controlled trial using this device assessed its impact on clinical outcomes prior to and following loop ileostomy reversal. A histology sub-study investigated chyme reinfusion’s impact on terminal ileal and rectal inflammation. A systematic review synthesized the extant understanding of terminal ileal motility as assessed by manometry. A manometry sub-study investigated the impact of chyme reinfusion on terminal ileal motility. RESULTS: Eight clinical variables were significantly associated with dehydration-related readmissions after ileostomy formation. High rates of unplanned readmissions following ileostomy formation was found in the local cohort with similar significant risk factors. The novel chyme reinfusion device was found to be acceptable and feasible in ileostomates. However, in the randomised trial, chyme reinfusion using this device did not lead to any significant differences in pre-operative or post-operative clinical outcomes nor in histological outcomes following ileostomy reversal. Terminal ileal manometry research demonstrated large variability in definitions of motility patterns and pattern characteristics. Some potentially significant differences in terminal ileal motility patterns were seen but these were inconclusive due to the small sample size. CONCLUSIONS: Several ileostomy patient groups are at high risk of readmissions with dehydration and this is a significant local population issue; use of the novel chyme reinfusion device did not lead to any significant improvements in pre-operative clinical, histological or motility outcomes, nor in post-operative recovery following ileostomy reversal and the current understanding of terminal ileal motility is limited with contradictory findings."],"dc:identifier.uri":["https://hdl.handle.net/2292/73819"],"dc:publisher":["ResearchSpace@Auckland"],"dc:rights":["Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated."],"dc:rights.uri":["https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm"],"dc:subject":["Colorectal Surgery","Ileostomy","Medical Device","Chyme Reinfusion","Dehydration"],"dc:title":["Studies of Loop Ileostomy Morbidity and the Potential Benefits of Chyme Reinfusion"],"dc:type":["Thesis"],"thesis:degree_discipline":["Surgery"],"thesis:degree_level":["Doctoral"],"thesis:degree_name":["PhD"],"thesis:institution_name":["The University of Auckland"]},"updated_at":"2026-07-24T01:06:10Z"}