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Long-Term Analysis of Respiratory-Related Complications Following Gastrostomy Placement with or without Fundoplication in Neurologically Impaired Children: A Retrospective Cohort Study
Article

Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study

1
Pediatric Surgery Department, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
2
Department of Pediatrics, “Vittore Buzzi” Children’s Hospital, 20154 Milan, Italy
3
Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
4
Department of Biomedical and Clinical Science “L. Sacco”, University of Milan, 20157 Milan, Italy
*
Author to whom correspondence should be addressed.
Received: 5 December 2020 / Revised: 11 January 2021 / Accepted: 14 January 2021 / Published: 17 January 2021
(This article belongs to the Special Issue Pediatric Gastroenterology and Nutrition)
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. View Full-Text
Keywords: esophageal atresia; malnutrition; growth; nutritional status; energy metabolism; feeding difficulty; dysphagia esophageal atresia; malnutrition; growth; nutritional status; energy metabolism; feeding difficulty; dysphagia
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MDPI and ACS Style

Destro, F.; Maestri, L.; Meroni, M.; Rebosio, F.; Del Re, G.; Mantegazza, C.; Calcaterra, V.; Pelizzo, G. Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study. Children 2021, 8, 55. https://0-doi-org.brum.beds.ac.uk/10.3390/children8010055

AMA Style

Destro F, Maestri L, Meroni M, Rebosio F, Del Re G, Mantegazza C, Calcaterra V, Pelizzo G. Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study. Children. 2021; 8(1):55. https://0-doi-org.brum.beds.ac.uk/10.3390/children8010055

Chicago/Turabian Style

Destro, Francesca, Luciano Maestri, Milena Meroni, Federico Rebosio, Giulia Del Re, Cecilia Mantegazza, Valeria Calcaterra, and Gloria Pelizzo. 2021. "Usefulness of Gastrojejunostomy Prior to Fundoplication in Severe Gastro-Esophageal Reflux Complicating Long-Gap Esophageal Atresia Repair: A Preliminary Study" Children 8, no. 1: 55. https://0-doi-org.brum.beds.ac.uk/10.3390/children8010055

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