Feeding jejunostomy in children: safety, effectiveness and perspectives

Area of Science:

• Pediatric surgery
• Gastroenterology
• Nutritional support

Background:

• Jejunal feeding (JF) is increasingly indicated in children.
• Surgical jejunostomy (SJ) has a reported high complication rate.
• Need to evaluate SJ safety, effectiveness, and patient selection.

Purpose of the Study:

• Assess the safety and effectiveness of surgical jejunostomy (SJ) in pediatric patients.
• Identify patient subgroups that benefit most from SJ.
• Analyze complications associated with SJ procedures.

Main Methods:

• Retrospective analysis of SJ procedures at Giannina Gaslini Children's Hospital (2014-2022).
• Data collected: demographics, medical history, indications, surgical techniques (Roux-en-Y jejunostomy - REYJ, omega jejunostomy - OJ), complications, and nutritional outcomes.
• Follow-up of nutritional outcomes and jejunostomy cessation/closure.

Main Results:

• 14 pediatric patients included; 64% had severe neurological impairment.
• Gastroesophageal reflux was the most common indication for SJ.
• No significant difference in outcomes between REYJ and OJ techniques.
• One major long-term complication occurred.
• 36% of patients discontinued JF after a median follow-up of 40 months.

Conclusions:

• Surgical jejunostomy (SJ) is a viable option for selected pediatric patients.
• SJ can serve as a temporary or bridge treatment.
• It may help prevent or delay the need for more invasive surgeries.
• Careful patient selection is crucial for successful outcomes.