Feeding jejunostomy in children: safety, effectiveness and perspectives.

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.