Preoperative Evaluation is not Predictive of Transpyloric Feeding Conversion in Gastrostomy Dependent Pediatric Patients

ABSTRACTObjectives:Limited literature exists as to whether preoperative gastrostomy (GT)evaluation may predict which patients will go onto require gastrojejunostomy tube (GJ) feeding. The goal of this study was to compare the preoperative evaluations between patients maintained on GT feeds versus patients who required conversion to GJ feeds.Methods:We identified patients at Boston Children's Hospital who underwent GT placement and required GJ feeding between 2006–2012. GT patients were matched according to age, neurologic, and cardiac status with GJ converted patients. Preoperative characteristics, rates of total hospitalizations, and respiratory related admissions were reviewed.Results:79 GJ patients (median (IQR): age 15 (4.3, 55.7) months; weight 8.8 (4.6, 14.5) kg) were matched with 79 GT patients (median (IQR): age 14.6 (4.7, 55.7) months; weight 8.5 (5, 13.6) kg). Median time from GT to GJ conversion was 8 (IQR 3, 16) months. Both groups had similar rates of successful preoperative nasogastric feeding trials (GT (84.5%) vs GJ (83.1%), p = 1.0), upper GI series (GT (89.1%) vs GJ (93.2%), p = 0.73), abnormal videofluoroscopic swallow studies (GT (53.8%) vs GJ (62.2%), p = 0.4), and completion of gastric emptying studies (GT (10.1%) vs GJ (5.1%), p = 0.22). No differences were seen in preoperative hospitalization rates (p = 0.25), respiratory admissions (p = 0.36), although GJ patients had a mean reduction in the number of hospitalization of −1.5 ± 0.5 days, p 

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