The Limitations of Gastro-Jejunal (G-J) Feeding Tubes in Children: A 9-Year Pediatric Hospital Database Analysis

Fortunato, John E.; Darbari, Anil; Mitchell, Sally E.; Thompson, Richard E.; Cuffari, Carmen
January 2005
American Journal of Gastroenterology;Jan2005, Vol. 100 Issue 1, p186
Academic Journal
BACKGROUND: A gastro-jejunal (G-J) feeding tube is a safe and useful temporizing method of providing enteral access in children. Although G-J tubes are often used to obviate the need for a surgical jejunostomy, their long-term use is often associated with mechanical failure.AIM: To review the clinically effective durability of G-J feeding tubes in providing enteral access in children.METHODS: We performed a retrospective review of 102 patients at the Johns Hopkins Children's Center from 1994–2003 whose underlying diagnosis necessitated the need for postpyloric enteral access.RESULTS: Long-term follow-up was obtained in 85 (48 M; 37 F) patients with a median (range) age of 2.0 (0.1–18.0) yr. The most common indication for G-J tube placement was gastroesophageal reflux with aspiration in 51 patients and feeding intolerance and vomiting in 19 patients. The mean (range) number of tube replacements was 2.2 (1–14) over a median (range) duration of follow-up of 39 (2–474) days. The indication for G-J tube replacement included: tube displacement (58), a clogged tube (41), and a cracked tube or ruptured balloon (35). In 52 cases, the cause for G-J tube replacement was undetermined.CONCLUSIONS: G-J feeding tubes are associated with the frequent need for tube maintenance and replacement and may not be the most feasible clinical option in providing long-term (>1 month) enteral access in children intolerant to gastrostomy tube feeds. Future studies are needed to develop innovative percutaneous jejunostomy tube placement techniques that facilitate long-term enteral access.(Am J Gastroenterol 2005;100:186–189)


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