Feeding jejunostomy in children: safety, effectiveness and perspectives
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In brief
In brief
This retrospective study evaluates surgical jejunostomy safety and effectiveness in 14 pediatric patients over 8 years, predominantly those with severe neurological impairment and gastroesophageal reflux. Results show low major complication rates and suggest jejunostomy serves best as temporary or bridge therapy in selected patients.
- Surgical jejunostomy in children shows acceptable safety with low major complication rates when used as temporary nutritional support.
- Most pediatric jejunostomy patients (64%) have severe neurological impairment; gastroesophageal reflux is the most common indication.
- Neither Roux-en-Y nor omega jejunostomy technique demonstrates clear superiority in pediatric patients.
- 36% of patients successfully discontinued jejunal feeding, suggesting it can serve as effective bridge therapy to avoid more invasive procedures.
- Surgical jejunostomy should be considered a temporary or bridge treatment in selected pediatric cases rather than definitive management.
Written by the GCMD Library team from the article.
Abstract
Purpose
Jejunal feeding (JF) indications in children have recently increased. However, surgical jejunostomy (SJ) is reported to be subjected to a high complication rate. The aim of the study is to focus on safety, effectiveness, and complications of SJ and to identify those categories of patients who could most benefit from it.
Methods
A retrospective analysis of all SJ performed at Giannina Gaslini Children’s Hospital between 2014 and 2022 was performed. Data were collected regarding demographics characteristics, past medical history, surgical indications, surgical technique (Roux-en-y (REYJ), omega jejunostomy (OJ)), complications and nutritional outcomes.
Results
Fourteen patients were included. Nine (64%) had severe neurological impairment. The most frequent indication for SJ was gastroesophageal reflux. REYJ was performed in five (36%) patients, OJ in nine (64%); no technique appears to be superior. One patient experienced a major long-term complication. After a follow-up of 40 months (range: 1–152), five (36%) patients discontinued JF: three (21%) successfully completed JF cessation, and two (14%) had their jejunostomy closed due to JF intolerance.
Conclusions
Based on our experience and on data available in the literature, SJ should be recommended in selected patients as temporary procedure or as bridge treatment to prevent or at least delay more invasive surgeries.