Journal of Pediatric Gastroenterology and Nutrition

Volume 77, Issue 2 pp. 267-273

Original Articles: Endoscopy and Procedures

Jejunal Feeding by Gastrojejunal Tube in Pediatric Refractory Gastroesophageal Reflux Disease

Nathan Faccioli MD,

Nathan Faccioli MD

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

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Anaïs Sierra MD,

Anaïs Sierra MD

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

University of Paris-Cité, Paris, France

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

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Alexis Mosca MD,

Alexis Mosca MD

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

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Marc Bellaïche MD,

Marc Bellaïche MD

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

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Hélène Lengliné MD,

Hélène Lengliné MD

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

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Arnaud Bonnard MD, PhD,

Arnaud Bonnard MD, PhD

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

University of Paris-Cité, Paris, France

INSERM UMR 1149, Paris, France

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Jérôme Viala MD, PhD,

Corresponding Author

Jérôme Viala MD, PhD

[email protected]

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

University of Paris-Cité, Paris, France

INSERM UMR 1149, Paris, France

Address correspondence and reprint requests to Jérôme Viala, MD, PhD, Department of Pediatric Gastroenterology and Nutrition, Robert-Debré Universitary Hospital, 48 Bd Sérurier, 75019 Paris, France (e-mail: [email protected]).Search for more papers by this author

Nathan Faccioli MD,

Nathan Faccioli MD

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

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Anaïs Sierra MD,

Anaïs Sierra MD

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

University of Paris-Cité, Paris, France

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

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Alexis Mosca MD,

Alexis Mosca MD

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

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Marc Bellaïche MD,

Marc Bellaïche MD

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

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Hélène Lengliné MD,

Hélène Lengliné MD

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

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Arnaud Bonnard MD, PhD,

Arnaud Bonnard MD, PhD

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

University of Paris-Cité, Paris, France

INSERM UMR 1149, Paris, France

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Jérôme Viala MD, PhD,

Corresponding Author

Jérôme Viala MD, PhD

[email protected]

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

University of Paris-Cité, Paris, France

INSERM UMR 1149, Paris, France

First published: 31 March 2023

https://doi.org/10.1097/MPG.0000000000003785

Citations: 2

The authors report no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML text of this article on the journal’s Web site (www.jpgn.org).

Clinical trials registration: ID: NCT05278689.

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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.

Graphical Abstract

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Citing Literature

Volume77, Issue2

August 2023

Pages 267-273