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Weight gain and resource utilization in infants after fundoplication versus gastrojejunostomy

Megan E Bouchard1, Christopher DeBoer2, Jennifer Li3

  • 1Department of Surgery, Division of Pediatric Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL, 60611, USA. mbouchard@luriechildrens.org.

Pediatric Surgery International
|January 6, 2022
PubMed

Insights

Laparoscopic fundoplication (LF) in children leads to better weight gain and fewer healthcare visits than gastrojejunostomy (GJ) tubes in the first year. Further studies are needed for long-term outcomes.

Area of Science:

  • Pediatric surgery
  • Gastroenterology
  • Nutritional support

Background:

  • Practice variation exists in managing pediatric feeding intolerance.
  • Laparoscopic fundoplication (LF) and gastrojejunostomy (GJ) tubes are common interventions.
  • Objective nutritional assessment is needed to compare these methods.

Purpose of the Study:

  • To compare weight gain between LF and GJ in children with feeding intolerance.
  • To evaluate healthcare utilization post-procedure for LF versus GJ.

Main Methods:

  • Retrospective cohort study of patients ≤ 2 years undergoing LF or GJ (2014-2019).
  • Collected data on patient characteristics, 1-year weight change, and healthcare encounters.
  • Used adjusted modeling to analyze weight-for-age Z-score changes.

Main Results:

  • Laparoscopic fundoplication (LF) group showed an average 0.85-unit increase in weight-for-age Z scores compared to gastrojejunostomy (GJ).
  • GJ cohort experienced more unplanned healthcare utilization (4.2 vs. 3.0 encounters).
  • GJ cohort required an average of 3.3 planned GJ exchanges within the first year.

Conclusions:

  • Laparoscopic fundoplication (LF) is associated with improved weight gain and reduced healthcare utilization in the first year post-procedure compared to gastrojejunostomy (GJ).
  • Further research on long-term outcomes and quality of life is recommended.
  • Standardized guidelines for pediatric feeding intolerance management are warranted.
Abstract

Keywords:
Enteral accessFundoplicationGastrojejunostomyWeight gain

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