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Conversion to Gastrojejunostomy Tubes in Developmentally-Disabled Children Intolerant to Gastrostomy Tube Feeding

DeRaddo, Joseph S.*,†; Skummer, Philip*; Rivera, Marcus; Kobayashi, Katsuhiro*

Journal of Pediatric Gastroenterology and Nutrition: May 9, 2019 - Volume Publish Ahead of Print - Issue - p
doi: 10.1097/MPG.0000000000002391
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ABSTRACT This study retrospectively evaluated the safety, impact on growth, and clinical outcomes of gastrojejunostomy tubes (GJTs) converted from surgically-placed gastrostomy tubes (GTs) in 44 developmentally-disabled children (median age: 28 months). The total duration of GJT follow-up was 31,378 device-days (median:643 device-days). Three major complications (aspiration pneumonia) were identified in 3 patients (6.8%), 63 minor complications in 31 patients (70.5%), and 202 tube maintenance issues (TMIs) in 41 patients (93.2%). A significantly increased average change in weight-for-age z-scores was observed at each 6-month interval that continued past 25 months. Patients above the median rate of TMIs had marginally significant lower z-scores across the study period (p = .06), compared to those below the median rate. GJTs were removed in six patients (13.6%) because of adequate oral intake at last follow-up. Conversion from GTs to GJTs was a viable option to achieve sustained growth in developmentally-disabled children. Frequency of TMIs may negatively impact their growth.

*Division of Interventional Radiology, Department of Radiology, Upstate Medical University

Division of Pediatric Gastroenterology and Hepatology, Department of Pediatrics, Upstate Medical University.

Address correspondence and reprint requests to Katsuhiro Kobayashi, MD, Department of Radiology, 750 East Adams street Syracuse, NY 13210 (e-mail: kobayask@upstate.edu).

Received 30 September, 2018

Accepted 29 April, 2019

Conflicts of Interest and Source of Funding: none declared

Authorship and Roles: Joseph S. DeRaddo – contributions in design, analysis and interpretation of data, constructing the manuscript, and final approval of the work. He agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Philip Skummer – contributions in design, analysis and interpretation of data, revising the manuscript, and final approval of the work. He agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Marcus Rivera – contributions in interpretation of data, revisions of the manuscript, and final approval of the paper. He agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Katsuhiro Kobayashi – contributions in conception of the project, design, analysis and interpretation of data, revising the manuscript, and final approval of the work. He agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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© 2019 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,