Application of nasojejunal nutrition tube after surgery for congenital gastric wall muscle layer defect in neonates

新生儿先天性胃壁肌层缺损手术后应用鼻空肠营养管

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Abstract

BACKGROUND: Neonates undergoing gastric repair require longer parenteral nutrition time, which may increase costs and the occurrence of complications. Early recovery of enteral nutrition is particularly necessary. Our aim is to explore the effects of early enteral nutrition provided through a nasojejunal tube in children with congenital defects of the gastric wall muscular layer after surgery. METHODS: A retrospective analysis was conducted on the clinical data of 42 children with congenital gastric wall muscle layer defects from 2015 to 2023. According to whether a nasojejunal tube was placed during the surgery, patients were divided into a nasojejunal tube feeding (NTF) group and a total parenteral nutrition (TPN) group. Analyzing the differences between the two groups, the observation indicators included postoperative recovery of intestinal function, feeding status, and complications. RESULTS: The time for achieving complete enteral feeding (17.21±3.51 vs. 20.00±4.22 days, P=0.03) and postoperative length of hospital stay (20.05±3.95 vs. 22.96±4.96 days, P=0.045) in the NTF group were significantly shorter than those in the TPN group. The incidence of postoperative abdominal distension in the NTF group was significantly lower than that in the TPN group (15.8% vs. 47.8%, P=0.03). There were no significant differences between the two groups in terms of cholestasis (5.3% vs. 17.4%, P=0.47), anastomotic leakage (5.3% vs. 4.3%, P=0.89), occurrence of neonatal necrotizing enterocolitis (NEC) (10.5% vs. 4.3%, P=0.86), vomiting (26.3% vs. 30.4%, P=0.77), and mortality rates (5.3% vs. 8.7%, P=0.67). CONCLUSIONS: For children with congenital defects of the gastric wall muscular layer, postoperative enteral nutrition via a nasojejunal feeding tube is feasible, which can shorten the time to reach full enteral nutrition and reduce hospitalization duration, with postoperative outcomes showing an improving trend. It is an important means to promote the recovery of neonates after gastric surgery.

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