Gastrojejunal (GJ) tube feeding: developing a service and evaluating associated complications in a paediatric surgical centre

Jejunal Feeding by Gastrojejunal Tube in Pediatric Refractory Gastroesophageal Reflux Disease

“…The specificity of our study was to analyze the outcome of jejunal nutrition by GJT several months after withdrawal of the device. In other reports, 6.2%–76% of children remained under GJT nutrition at the end of the study (7–12). Moreover, we showed that GERD control with no need of antireflux surgery was sustainable with a median follow up of >2 years after GJT removal.…”

“…In neurologically impaired patients, the antireflux surgery suffers from a high failure rate of 33%–47% (20). However, none of the 33 neurologically impaired children fed by GJT needed antireflux surgery and 76% underwent jejunal nutrition by GJT at the end of the study (12). As we observed no difference in success rate of GJT in neurologically impaired patients (62% after 2 years), the jejunal nutrition could be an interesting alternative to control GERD in these patients.…”

“…To date, there are few literatures on the nutritional outcomes of the patients requiring jejunal nutrition with GJT. Previous reports showed that about 25% of children who needed GJT placement were able to be successfully transitioned to gastric nutrition without subsequent surgery, but these has always been with a limited amount of patients, for a specific population or with other GJT indication that GERD included (7)(8)(9)(10)(11)(12). GERD usually resolves spontaneously with children aging.…”

Clinical characteristics of children with severe neurologic impairment: A scoping review

“…The 102 published clinical studies about children with SNI fall into seven clinical topics. Gastroesophageal reflux and feeding tubes ( n = 57, 56%) was the most common topic, with subtopics of gastroesophageal reflux ( n = 7), 7,42–44,102–104 gastrostomy tube outcomes ( n = 24), 9,39,45,46,56–65,81–84,105–110 and antireflux procedures ( n = 26) 8,47–55,66–71,85,86,111–118 . Other topics included aspiration and respiratory issues ( n = 13, 13%) 72,73,87–93,119–122 ; symptoms, palliative care, and quality of life ( n = 12, 12%) 38,41,74–77,94–97,123,124 ; growth and endocrinology ( n = 10, 10%) 78,98,99,125–131 ; caregivers and care burden ( n = 7, 7%) 10,37,40,79,80,100,132 ; other ( n = 2, 2%) 101,133 ; and musculoskeletal ( n = 1, 1%) 134 .…”

Gastroesophageal Reflux Treatment in Infancy Through Young Adulthood

“…Another surgical option for management of GERD is the postpyloric feeds, which have shown to reduce reflux numbers down to fundoplication-equivalent ranges and have equivalent clinical outcomes even in medically complex patients (91,92). Postpyloric feeding can serve as a critical bridge to outgrowing reflux symptoms; studies suggest that ,15% of patients with postpyloric feeds require any additional surgical procedures, suggesting that this is an effective option for patients with enteral tubes as a bridge to outgrowing symptoms or as a temporizing therapy at times of acute illness (93,94).…”