Gastrojejunal Feeding Tube Use by Gastroenterologists in a Pediatric Academic Center

Background and Objectives: : Enteral feeding through gastrojejunal (GJ) tubes is an established method of nutrition for patients with feeding difficulty who do not tolerate intragastric feedings. The pediatric literature about the long-term outcome, safety, and complications of different GJ tubes and placement methods is lacking. Our study aims to provide information about indications, techniques, and long-term outcome of GJ tube use in children. Methods: Retrospective chart review for GJ tube placement procedures was used at our center for 10 years (1999-2009). Data collected included demographics, placement indications, underlying diagnosis, tube type, placement methods, complications, tube survival, and patient outcome. Results: Thirty-three patients using GJ tubes were identified, with a total of 160 successful procedures documented (overall success rate of 97.6%). At initial placement, the mean age was 6 years (range 0.6-21.6) and the mean weight was 19.4 kg (range 6.6-72.2). Patients had a mean of 4.9 tubes placed per patient (range 1-20) during a follow-up of 26.8 months (range 0.4-115.3). The most common indications for replacement included accidental dislodgement, tube obstruction, coiling back into the stomach, and broken tube component. At the end of the study, 39% continued using GJ tubes, 30% were transitioned back to gastrostomy or oral feeds, and 15% underwent a surgical intervention. Conclusions: Long-term GJ tube use is possible and safe in children. Various feeding tubes and placement methods can be used by pediatric gastroenterologists to provide long-term jejunal feeds in children.