Weight gain and resource utilization in infants after fundoplication versus gastrojejunostomy

Megan E. Bouchard*, Christopher DeBoer, Jennifer Li, Andrew Hu, Steven Papastefan, Samuel Linton, Jared R. Green, Fizan Abdullah, Seth D. Goldstein

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Purpose: There is wide practice variation in the use of laparoscopic fundoplication (LF) versus gastrojejunostomy (GJ) tube insertion for children who do not tolerate gastric feeds. Using weight gain as an objective proxy of adequate nutrition, we sought to evaluate the difference in weight gain between LF and GJ. Methods: A retrospective, cohort study was conducted of patients ≤ 2 years who underwent LF or GJ between 2014 and 2019 at a single institution. Patient characteristics, change in weight 1-year post-procedure and frequency of unplanned healthcare utilization encounters were collected and examined. Results: A total of 125 patients (50.4%LF, 49.6%GJ) were identified. Adjusted modeling demonstrated that on average, there was an additional 0.85-unit increase in weight-for-age Z scores in the LF compared to the GJ cohort (p = 0.01). The GJ cohort had significantly more unplanned healthcare utilization encounters (4.2, SD 3.4) compared to LF (3.0, SD 3.1) (p = 0.03). Furthermore, the GJ cohort underwent an average of 3.3 planned GJ exchanges within 1-year post-procedure. Conclusion: In the first year post-operatively, LF is associated with increased weight gain and fewer unplanned and overall healthcare encounters compared to GJ. Long-term outcomes including weight gain and quality-of-life measures should be studied to develop standardized guidelines for this common clinical scenario.

Original languageEnglish (US)
Pages (from-to)485-492
Number of pages8
JournalPediatric Surgery International
Volume38
Issue number3
DOIs
StatePublished - Mar 2022

Keywords

  • Enteral access
  • Fundoplication
  • Gastrojejunostomy
  • Weight gain

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

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