Jejunal Feeding by Gastrojejunal Tube in Pediatric Refractory Gastroesophageal Reflux Disease

Author:

Faccioli Nathan1,Sierra Anaïs123,Mosca Alexis1,Bellaïche Marc1,Lengliné Hélène1,Bonnard Arnaud245,Viala Jérôme125

Affiliation:

1. Department of Pediatric Gastroenterology and Nutrition, Robert-Debré Universitary Hospital, APHP, Paris, France

2. University of Paris-Cité, Paris, France

3. Department of Pediatrics, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France

4. Department of Pediatric Surgery and Urology, Robert-Debré Universitary Hospital, APHP, Paris, France

5. INSERM UMR 1149, Paris, France.

Abstract

Objectives: 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. Methods: 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). Results: 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. Conclusions: 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.

Publisher

Wiley

Subject

Gastroenterology,Pediatrics, Perinatology and Child Health

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