Jejunal Feeding by Gastrojejunal Tube in Pediatric Refractory Gastroesophageal Reflux Disease.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
medline:
24
7
2023
pubmed:
21
7
2023
entrez:
21
7
2023
Statut:
ppublish
Résumé
The objective of this study is to determine whether jejunal nutrition by gastrojejunal tube (GJT) could be a therapeutic option for refractory gastroesophageal reflux disease (GERD), avoiding further antireflux surgery. A monocentric retrospective study was conducted for all children <18 years who underwent GJT placement to treat GERD. We collected data at the first GJT placement, 5 months after last GJT withdrawal, and at the end of the follow-up (June 2021). Among 46 GERD patients with 86 GJT, 32 (69.6%) and 30 (65.2%) avoided antireflux surgery 5 and 28 months, respectively, after the definitive GJT removal. Five months after GJT removal, discharge from hospital, transition to gastric nutrition, GERD complications, and treatment were significantly improved. Median age and weight at the first GJT placement were 7 months and 6.8 kg. Patients had digestive comorbidities or complicated GERD in 69.6% and 76.1% patients, respectively. The median duration of jejunal nutrition using GJT was 64.5 days. GJT had to be removed in 63 (75.9%) cases for technical problems. Jejunal nutrition by GJT could be an alternative to antireflux surgery avoiding sustainably antireflux surgery in most of complicated GERD patients. The high frequency of mechanical complications raises that these devices should be technically improved.
Identifiants
pubmed: 37477887
doi: 10.1097/MPG.0000000000003785
pii: 00005176-202308000-00025
doi:
Banques de données
ClinicalTrials.gov
['NCT05278689']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
267-273Informations de copyright
Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
Déclaration de conflit d'intérêts
The authors report no conflicts of interest.
Références
Rosen R, Vandenplas Y, Singendonk M, et al. Pediatric gastroesophageal reflux clinical practice guidelines: joint recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN) and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN). J Pediatr Gastroenterol Nutr 2018;66:516–54.
Wockenforth R, Gillespie CS, Jaffray B. Survival of children following Nissen fundoplication. Br J Surg 2011;98:680–5.
Baerg J, Thorpe D, Bultron G, et al. A multicenter study of the incidence and factors associated with redo Nissen fundoplication in children. J Pediatr Surg 2013;48:1306–11.
Broekaert IJ, Falconer J, Bronsky J, et al. The use of jejunal tube feeding in children: a position paper by the Gastroenterology and Nutrition Committees of the European Society for Paediatric Gastroenterology, Hepatology, and Nutrition 2019. J Pediatr Gastroenterol Nutr 2019;69:239–58.
Livingston MH, Shawyer AC, Rosenbaum PL, Jones SA, Walton JM. Fundoplication and gastrostomy versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: a systematic review and meta-analysis. J Pediatr Surg 2015;50:707–14.
Stone B, Hester G, Jackson D, et al. Effectiveness of fundoplication or gastrojejunal feeding in children with neurologic impairment. Hosp Pediatr 2017;7:140–8.
Wilson RE, Rao PK, Cunningham AJ, Dewey EN, Krishnaswami S, Hamilton NA. A natural history of gastrojejunostomy tubes in children. J Surg Res 2020;245:461–6.
DeRaddo JS, Skummer P, Rivera M, Kobayashi K. Conversion to gastrojejunostomy tubes in developmentally disabled children intolerant to gastrostomy tube feeding. J Pediatr Gastroenterol Nutr. 2019;69:e75–8.
Singh RR, Eaton S, Roebuck DJ, et al. Surgical jejunostomy and radiological gastro-jejunostomy tube feeding in children: risks, benefits and nutritional outcomes. Pediatr Surg Int 2018;34:951–6.
Onwubiko C, Weil BR, Bairdain S, et al. Primary laparoscopic gastrojejunostomy tubes as a feeding modality in the pediatric population. J Pediatr Surg 2017;52:1421–5.
Elmehdi S, Ley D, Aumar M, et al. Endoscopic gastrojejunostomy in infants and children. J Pediatr 2022;244:115–119.e1.
Williams R, Ghattaura HS, Hallows R. Gastrojejunal (GJ) tube feeding: developing a service and evaluating associated complications in a paediatric surgical centre. Pediatr Surg Int 2022;38:867–73.
Michaud L, Robert-Dehault A, Coopman S, Guimber D, Turck D, Gottrand F. One-step percutaneous gastrojejunostomy in early infancy. J Pediatr Gastroenterol Nutr 2012;54:820–1.
Harbaugh CM, Wu C, Demehri F, Gadepalli SK, Ehrlich PF. Impact of practice change on intestinal perforation risk for pediatric gastrojejunostomy tube placement. J Pediatr Surg 2019;54:1041–4.
Campwala I, Perrone E, Yanni G, Shah M, Gollin G. Complications of gastrojejunal feeding tubes in children. J Surg Res 2015;199:67–71.
Al-Zubeidi D, Demir H, Bishop WP, Rahhal RM. Gastrojejunal feeding tube use by gastroenterologists in a pediatric academic center. J Pediatr Gastroenterol Nutr 2013;56:523–7.
Godbole P, Margabanthu G, Crabbe DC, et al. Limitations and uses of gastrojejunal feeding tubes. Arch Dis Child 2002;86:134–7.
Wales PW, Diamond IR, Dutta S, et al. Fundoplication and gastrostomy versus image-guided gastrojejunal tube for enteral feeding in neurologically impaired children with gastroesophageal reflux. J Pediatr Surg 2002;37:407–12.
Demehri FR, Simha S, Herrman E, et al. Analysis of risk factors contributing to morbidity from gastrojejunostomy feeding tubes in children. J Pediatr Surg 2016;51:1005–9.
Diaz DM, Gibbons TE, Heiss K, Wulkan ML, Ricketts RR, Gold BD. Antireflux surgery outcomes in pediatric gastroesophageal reflux disease. Am J Gastroenterol 2005;100:1844–52.
Michaud L, Coopman S, Guimber D, Sfeir R, Turck D, Gottrand F. Percutaneous gastrojejunostomy in children: efficacy and safety. Arch Dis Child 2012;97:733–4.
Picoraro JA, Pierog A, Reilly NR, Mencin AA. Gastrojejunal tube placement through an established gastrostomy via an endoscopic transgastric approach in a pediatric population. Gastrointest Endosc 2015;82:1025–30.
Morse J, Baird R, Muchantef K, Levesque D, Morinville V, Puligandla PS. Gastrojejunostomy tube complications – a single center experience and systematic review. J Pediatr Surg 2017;52:726–33.
Mahant S, Pastor AC, Deoliveira L, Nicholas DB, Langer JC. Well-being of children with neurologic impairment after fundoplication and gastrojejunostomy tube feeding. Pediatrics 2011;128:e395–403.