A gastro-jejunal feeding tube is a safe and useful temporizing method of providing enteral access in children.
Although gastro-jejunal tubes are often used to obviate the need for a surgical jejunostomy, their long-term use is often associated with mechanical failure.
Dr Cuffari and colleagues reviewed the clinically effective durability of G-J feeding tubes in providing enteral access in children.
The investigators performed a retrospective review of 102 patients at the Johns Hopkins Children's Center from 1994 to 2003 whose underlying diagnosis necessitated the need for postpyloric enteral access.
| Indication for gastro-jejunal tube placement was GERD, aspiration, feeding intolerance and vomiting|
|American Journal of Gastroenterology|
Long-term follow-up was obtained in 85 (48 male and 37 female) patients with an age range of 11 months to 8 years.
The research team found that the most common indication for gastro-jejunal tube placement was gastroesophageal reflux with aspiration in 51 patients and feeding intolerance and vomiting in 19 patients.
The team also established that the mean number of tube replacements was 2 over a median duration of follow-up of 39 days.
The indication for gastro-jejunal tube replacement included tube displacement, a clogged tube, and a cracked tube or ruptured balloon.
The investigators noted that in 52 cases, the cause for gastro-jejunal tube replacement was undetermined.
Dr Cuffari concludes, “Gastro-jejunal feeding tubes are associated with the frequent need for tube maintenance and replacement.”
“They may not be the most feasible clinical option in providing long-term of more than1 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.”