Document Detail

A modified feeding Roux-en-Y jejunostomy in the neurologically damaged child.
MedLine Citation:
PMID:  9126760     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Feeding tube access with an antireflux procedure is frequently necessary in children with severe neurological deficits. Fundoplication in this particular group of patients has many complications and a reported failure rate of 40% to 50%. Recently, the use of a feeding Roux-en-Y jejunostomy has been advocated in this population. METHODS: Since December 1993, over a 6-month period, the authors performed 12 Roux-en-Y jejunostomies. All children had documented gastroesophageal reflux. One patient had a prior failed Nissen fundoplication, and none of these patients were feeding significantly by mouth. Postoperative follow-up has been 12 months. RESULTS: There were no deaths in this series. One patient required early revision of the stoma because of marked prolapse. One 11-month-old infant required reoperation 7 days postoperatively because of tube dislodgment. Eight of the 12 patients required out-patient procedures to unplug or replace the jejunostomy tube. CONCLUSION: The operation may be beneficial in a subset of neurologically impaired children who will never be able to ingest significant calories by mouth. It may also be useful after a failed fundoplication. The main postoperative complications were plugging and dislodgment of the jejunostomy tube, which if they occurred early, required x-ray confirmation for catheter placement.
B F Gilchrist; F I Luks; F G DeLuca; C W Wesselhoeft
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric surgery     Volume:  32     ISSN:  0022-3468     ISO Abbreviation:  J. Pediatr. Surg.     Publication Date:  1997 Apr 
Date Detail:
Created Date:  1997-06-27     Completed Date:  1997-06-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0052631     Medline TA:  J Pediatr Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  588-9     Citation Subset:  IM    
Division of Pediatric Surgery, Brown University School of Medicine, Providence, RI 02903, USA.
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MeSH Terms
Anastomosis, Roux-en-Y
Enteral Nutrition*
Gastroesophageal Reflux / complications,  therapy
Jejunostomy / methods*
Nervous System Diseases* / complications
Postoperative Complications

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