Feeding jejunostomy in children: safety, effectiveness and perspectives.

IF 1.5 3区医学 Q2 PEDIATRICS

Pediatric Surgery International Pub Date : 2024-11-27 DOI:10.1007/s00383-024-05915-6

Valentina Forlini, Caterina Sacchetti, Paolo Gandullia, Stefano Avanzini, Girolamo Mattioli, Michela Cing Yu Wong

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引用次数: 0

Abstract

Purpose: Jejunal feeding (JF) indications in children have recently increased. However, surgical jejunostomy (SJ) is reported to be subjected to a high complication rate. The aim of the study is to focus on safety, effectiveness, and complications of SJ and to identify those categories of patients who could most benefit from it.

Methods: A retrospective analysis of all SJ performed at Giannina Gaslini Children's Hospital between 2014 and 2022 was performed. Data were collected regarding demographics characteristics, past medical history, surgical indications, surgical technique (Roux-en-y (REYJ), omega jejunostomy (OJ)), complications and nutritional outcomes.

Results: Fourteen patients were included. Nine (64%) had severe neurological impairment. The most frequent indication for SJ was gastroesophageal reflux. REYJ was performed in five (36%) patients, OJ in nine (64%); no technique appears to be superior. One patient experienced a major long-term complication. After a follow-up of 40 months (range: 1-152), five (36%) patients discontinued JF: three (21%) successfully completed JF cessation, and two (14%) had their jejunostomy closed due to JF intolerance.

Conclusions: Based on our experience and on data available in the literature, SJ should be recommended in selected patients as temporary procedure or as bridge treatment to prevent or at least delay more invasive surgeries.

查看原文本刊更多论文

儿童喂养空肠造口术：安全性、有效性和前景。

目的：最近，儿童空肠喂养（JF）的适应症有所增加。然而，据报道手术空肠造口术（SJ）的并发症发生率较高。本研究旨在关注空肠造口术的安全性、有效性和并发症，并确定哪些类别的患者最有可能从中受益：方法：对2014年至2022年期间在吉安尼娜-加斯利尼儿童医院实施的所有SJ进行回顾性分析。收集了有关人口统计学特征、既往病史、手术适应症、手术技术（Roux-en-y（REYJ）、Ω空肠造口术（OJ））、并发症和营养结果的数据：结果：共纳入 14 名患者。结果：共纳入 14 例患者，其中 9 例（64%）有严重的神经损伤。SJ最常见的适应症是胃食管反流。五名患者（36%）接受了REYJ手术，九名患者（64%）接受了OJ手术。一名患者出现了严重的长期并发症。经过 40 个月（范围：1-152）的随访，5 名（36%）患者停止了 JF：3 名（21%）成功停止了 JF，2 名（14%）因不耐受 JF 而关闭了空肠造口：根据我们的经验和文献中的数据，SJ 应作为临时手术或桥梁治疗推荐给特定患者，以防止或至少推迟更具侵入性的手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pediatric Surgery International 医学-外科

CiteScore

3.00

自引率

5.60%

发文量

215

审稿时长

3-6 weeks

期刊介绍： Pediatric Surgery International is a journal devoted to the publication of new and important information from the entire spectrum of pediatric surgery. The major purpose of the journal is to promote postgraduate training and further education in the surgery of infants and children. The contents will include articles in clinical and experimental surgery, as well as related fields. One section of each issue is devoted to a special topic, with invited contributions from recognized authorities. Other sections will include: -Review articles- Original articles- Technical innovations- Letters to the editor