A Natural History of Gastrojejunostomy Tubes in Children

Rachel E. Wilson, Pavithra K. Rao, Aaron J. Cunningham, Elizabeth N. Dewey, Sanjay Krishnaswami, Nicholas Hamilton

Research output: Contribution to journalArticle

Abstract

Background: Gastrojejunostomy (GJ) tubes are frequently used to provide nutrition in patients who do not tolerate gastric feeding. Despite their widespread use, there is little literature on the lifespan of GJ tubes, reasons for failure, and recommendations for optimal techniques and timing of replacement. We aimed to evaluate the natural history of GJ tubes in pediatric patients. Materials and methods: We reviewed all pediatric patients who underwent GJ tube placement or exchange at our institution from January 2012 to July 2018. Demographic data, time, and indication for replacement or removal of GJ tubes were collected. End points were permanent removal of GJ tube or mortality. Results: Seventy-nine patients underwent 205 GJ tube procedures with a median of 2 GJ tubes per patient. Median GJ tube lifespan was 98 d (interquartile range = 54-166). The two most common indications for tube exchange were structural or mechanical problems (43.1%) and GJ tube dislodgement (34.6%). Although most GJ tube exchanges (66%) were performed under general anesthesia or with moderate sedation, 34% of exchanges were done without sedation. During the study period, 12 patients (15.2%) died from their primary disease, nine patients (11.4%) required subsequent fundoplication, one (1.3%) underwent a jejunostomy, and 23 (29.1%) progressed to gastric feeds without fundoplication at a median time of 208 d. Conclusions: GJ tubes offer a safe and effective feeding option in patients intolerant of gastric feeding. GJ tubes fail most commonly from intrinsic structural or mechanical issues, and many patients ultimately tolerate gastric feeds without need for further intervention. Exchange of tubes without anesthesia is a viable option.

Original languageEnglish (US)
Pages (from-to)461-466
Number of pages6
JournalJournal of Surgical Research
Volume245
DOIs
StatePublished - Jan 1 2020

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Gastric Bypass
Natural History
Stomach
Fundoplication
Pediatrics
Jejunostomy
Conscious Sedation
General Anesthesia
Anesthesia

ASJC Scopus subject areas

  • Surgery

Cite this

A Natural History of Gastrojejunostomy Tubes in Children. / Wilson, Rachel E.; Rao, Pavithra K.; Cunningham, Aaron J.; Dewey, Elizabeth N.; Krishnaswami, Sanjay; Hamilton, Nicholas.

In: Journal of Surgical Research, Vol. 245, 01.01.2020, p. 461-466.

Research output: Contribution to journalArticle

Wilson, Rachel E. ; Rao, Pavithra K. ; Cunningham, Aaron J. ; Dewey, Elizabeth N. ; Krishnaswami, Sanjay ; Hamilton, Nicholas. / A Natural History of Gastrojejunostomy Tubes in Children. In: Journal of Surgical Research. 2020 ; Vol. 245. pp. 461-466.
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