Laparoscopic Roux-en-Y feeding jejunostomy as a long-term solution for severe feeding problems in children

Area of Science:

• Pediatric Surgery
• Gastroenterology
• Minimally Invasive Procedures

Background:

• Enteral feeding is challenging for pediatric patients with gastric emptying disorders, often leading to complications with traditional methods.
• Existing alternatives like open jejunostomy or Roux-en-Y jejunostomy are either invasive or associated with significant complications.
• Limited data exists on the efficacy and safety of laparoscopic Roux-en-Y feeding jejunostomy (LRFJ) in this population.

Purpose of the Study:

• To evaluate the outcomes of the laparoscopic Roux-en-Y feeding jejunostomy (LRFJ) procedure in children with oral feeding intolerance due to delayed gastric emptying.
• To assess complication rates (short and long-term) and parental satisfaction following LRFJ.

Main Methods:

• Retrospective case-series analysis of pediatric patients (0-18 years) who underwent LRFJ.
• Data collected on LRFJ procedures performed between August 2011 and December 2020.
• Evaluation of complication incidence, severity (Clavien-Dindo classification), and parental satisfaction.

Main Results:

• Twelve pediatric patients underwent LRFJ for delayed gastric emptying.
• A total of 16 complications were observed in 8 out of 12 patients (67%).
• Complication severity included 13 Grade I, 1 Grade II, and 2 Grade IIIB (Clavien-Dindo). Parental satisfaction was high, with 11 out of 12 families satisfied.

Conclusions:

• LRFJ is a safe and effective minimally invasive technique for definitive enteral feeding in children with gastric emptying disorders.
• Despite common minor complications, LRFJ leads to high parental satisfaction and resolves oral feeding intolerance.
• LRFJ represents a valuable alternative to traditional and more invasive feeding methods in pediatric patients.