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Limitations and uses of gastrojejunal feeding tubes
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  1. P Godbole1,
  2. G Margabanthu4,
  3. D C Crabbe1,
  4. A Thomas4,
  5. J W L Puntis2,
  6. G Abel2,
  7. R J Arthur3,
  8. M D Stringer1
  1. 1Department of Paediatric Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  2. 2Department of Paediatric Gastroenterology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  3. 3Department of Paediatric Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
  4. 4Department of Paediatric Gastroenterology, Royal Manchester Childrens Hospital, Manchester, UK
  1. Correspondence to:
    Mr M D Stringer, Consultant Paediatric Surgeon, Leeds Teaching Hospitals, Level 8, Gledhow Wing, St James's University Hospital, Leeds LS9 7TF, UK;
    mdstringer{at}dial.pipex.com

Abstract

Background: Gastrostomy feeding is a well established alternative method to long term nasogastric tube feeding. Many such patients have gastro-oesophageal reflux (GOR) and require a fundoplication. A transgastric jejunal tube is an alternative when antireflux surgery fails, or is hazardous or inappropriate.

Aims: To review experience of gastrojejunal (G-J) feeding over six years in two regional centres in the UK.

Methods: Retrospective review of all children who underwent insertion of a G-J feeding tube.

Results: There were 18 children, 12 of whom were neurologically impaired. G-J tubes were inserted at a median age of 3.1 years (range 0.6–14.7) because of persistent symptoms after Nissen fundoplication (n = 8) or symptomatic GOR where fundoplication was inappropriate. Four underwent primary endoscopic insertion of the G-J tube; the remainder had the tube inserted via a previous gastrostomy track. Seventeen showed good weight gain. There was one insertion related complication. During a median follow up of 10 months (range 1–60), four experienced recurrent aspiration, bilious aspirates, and/or diarrhoea. There were 65 tube related complications in 14 patients, necessitating change of the tube at a median of 74 days. Jejunal tube migration was the commonest problem. Five died from complications of their underlying disease.

Conclusions: Although G-J feeding tubes were inserted safely and improved nutritional status, their use was associated with a high rate of morbidity. Surgical alternatives such as an Roux-en-Y jejunostomy may be preferable.

  • percutaneous endoscopic gastrostomy
  • gastrojejunal feeding tube
  • G-J, gastrojejunal
  • GOR, gastro-oesophageal reflux
  • PEG, percutaneous endoscopic gastrostomy
  • PEG-J tube, gastrojejunal tube inserted by percutaneous endoscopy

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