Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study
Articolo
Data di Pubblicazione:
2021
Citazione:
Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study / F. Destro, L. Maestri, M. Meroni, F. Rebosio, G. Del Re, C. Mantegazza, V. Calcaterra, G. Pelizzo. - In: CHILDREN. - ISSN 2227-9067. - 8:1(2021), pp. 55.1-55.9. [10.3390/children8010055]
Abstract:
Background: Gastro-esophageal reflux disease (GERD), requiring surgical correction, and nutritional problems are reported after long-gap esophageal atresia (LGEA) repair and might jeopardize the postoperative course in some babies. We report an exploratory evaluation of the role of transgastric jejunostomy (TGJ) as a temporary nutritional tool before surgery for GERD in LGEA. Methods: Seven infant patients operated on for LGEA with intra-thoracic gastro-esophageal junction (GEJ) and growth failure, requiring improvement in their nutritional profile in anticipation of surgery, were retrospectively evaluated. Post-surgical follow-up, including growth evolution, complications, and parental quality of life (QoL), were considered. Results: The TGJ was placed at a mean age of 8.6 +/- 5.6 months. The procedure was uneventful and well-tolerated in all seven cases. At 6.6 +/- 2.0 months after TGJ placement, significant weight gain (weight z-score -2.68 +/- 0.8 vs -0.9 +/- 0.2, p < 0.001) was recorded, allowing the GERD surgery to proceed. A significant difference in hospital admissions between 3 months before and post-TGJ insertion was noted (4.8 +/- 0.75 vs. 1.6 +/- 0.52, p < 0.01). A significant amelioration of QoL after TGJ placement was also recorded; in particular, the biggest improvements were related to parents' perceptions of the general health and emotional state of their babies (p < 0.001). Conclusions: The placement of TGJ as a temporary nutritional tool in selected cases of LGEA could improve nutritional conditions and parental QoL before fundoplication, allowing successful surgical treatment of GERD to be carried out.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
dysphagia; energy metabolism; esophageal atresia; feeding difficulty; growth; malnutrition; nutritional status
Elenco autori:
F. Destro, L. Maestri, M. Meroni, F. Rebosio, G. Del Re, C. Mantegazza, V. Calcaterra, G. Pelizzo
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