Is postoperative transanastomotic feeding beneficial in neonates with congenital duodenal obstruction?

Abstract

Purpose We aimed to evaluate possible positive and negative effects of postoperative use of transanastomotic feeding tube (TAFT) in neonates operated for congenital duodenal obstruction (CDO). Methods This is a retrospective study reviewing medical records of neonates operated for CDO during 2003–2020 and comparing postoperative feeding outcomes and complications in patients with and without TAFT. Approval from the hospital’s data protection officer was obtained. Results One hundred patients, 59% girls, were included, and 37% received TAFT. Mean birth weight and gestational age were 2628 (675.1) grams and 36.6 (2.4) weeks, respectively. Furthermore, 45% had no other malformations, and 36% had Down syndrome. Patient demographics were similar for TAFT and not-TAFT patients, except that not-TAFT neonates weighed median 335 g less (p = 0.013). The TAFT group got parenteral nutrition 2 days shorter (p < 0.001) and started enteral feeds 1.5 days earlier (p < 0.001) than the not-TAFT group. Fewer neonates with TAFT got a central venous catheter [65 vs 89%, (p = 0.008)]. In the TAFT group, 67% were breast fed at discharge compared to 49% in the not-TAFT group (p = 0.096). Conclusion Neonates with TAFT had earlier first enteral feed, fewer days with parenteral nutrition and fewer placements of central venous catheters.

Congenital Duodenal Obstruction: National Trends in Management and Outcomes during the Last Quarter of a Century in Norway

“…However, TAFT was not associated with reduced LOS or fewer complications. This is consistent with several other studies exploring the effect of TAFT in neonates with CDO (15,16,28). Although more use of TAFT is unlikely to reduce LOS and complications, it may have other benefits, such as a reduced need for PN and earlier enteral feeding (15,16,28).…”

“…This is consistent with several other studies exploring the effect of TAFT in neonates with CDO. 15,16,28 Although more use of TAFT is unlikely to reduce LOS and complications, it may have other benefits, such as a reduced need for PN and earlier enteral feeding. 15,16,28 The prenatal detection rate increased and stabilized at around 50% during the study period.…”

“…15,16,28 Although more use of TAFT is unlikely to reduce LOS and complications, it may have other benefits, such as a reduced need for PN and earlier enteral feeding. 15,16,28 The prenatal detection rate increased and stabilized at around 50% during the study period. A large populationbased European study from 1996 to 1998 showed a detection rate of 60%, 29 which is more than twice the detection rate we found in period 1 (1995-2003).…”

Is the Use of Transanastomotic Tube Beneficial in Pyloric Atresia?

“…According to the preference of the surgeon, Heineke-Mikulicz pyloroplasty was performed on 9 (75%) cases, and gastroduodenostomy was performed on 3 (25%) cases. For all cases, the mean time to postoperative feeding was 3.1 ±2.2 (1-7) days, and the mean length of stay was 11.5± 3.8 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19) days. The mean weight at discharge was 3048 ± 538 (2160-4050) grams.…”

“…In the postoperative period after CPA surgery, gastric retention due to dysmotility may develop and enteral feeding may become problematic. In the postoperative first days, patients are fed either parenterally (PN) or they may require enteral nutrition support by transanastomotic feeding tubes (TATs) (9,10). Many advantages of TAT placement have been reported such as earlier transition to enteral feeding, less need for central venous catheters and shorter length of stay (11)(12)(13)(14)(15).…”