Comparative analysis of balloon vs solid internal bumper gastro-jejunal tubes in children: a review of outcomes.
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All Authors
Naeem, M.
Ali, MS.
Khan, S.
Alma'aitah, SW.
Aworanti, OM.
LTHT Author
Naeem, Mushkbar
Ali, Muhammad Saad
Khan, Saifullah
Almaaitah, Suhib Waleed
Olugbenga Aworanti, Michael
Ali, Muhammad Saad
Khan, Saifullah
Almaaitah, Suhib Waleed
Olugbenga Aworanti, Michael
LTHT Department
Leeds Children's Hospital
Paediatric Surgery
Paediatric Surgery
Non Medic
Publication Date
2026
Item Type
Journal Article
Comparative Study
Language
Subject
ENTERAL NUTRITION , INTUBATION, GASTROINTESTINAL , TREATMENT OUTCOME , JEJUNUM , EQUIPMENT DESIGN
Subject Headings
Abstract
BACKGROUND: We compared two types of gastro-jejunal (GJ) tubes used in children: Freka R percutaneous endoscopic GJ tube (FPEGJ) with solid internal bumpers and balloon gastro-jejunal tubes (BGJ). Despite differences in design, comparative data on safety, durability, and complications remain limited.
METHODS: A retrospective review was performed of 69 children with active GJ tubes as of August 2024. Each tube episode lasted until replacement to a different tube type under general anaesthesia. Demographic data, complications, and frequency of elective and unplanned tube changes were analysed.
RESULTS: Forty-one children(59%) had an initial FPEGJ, and their median weight was significantly lower than those who had an initial BGJ (7.9 vs. 21.4 kg, p < 0.001). In total, 56 FPEGJ and 48 BGJ tube episodes were reviewed. Over a median of 14.5 months for FPEGJ and 37 months for BGJ (p < 0.001), BGJ required more routine changes (0.12 vs. 0.0 changes/month). However, acute change rates were similar (0.05 vs. 0.06 changes/month, p = 0.61), with Poisson regression adjusting for duration showing no significant difference (incidence rate ratio 0.97, p = 0.82). The most common cause for acute replacement was jejunal limb displacement (32% FPEGJ, 34% BGJ), followed by FPEGJ distal migration (19%) and BGJ balloon rupture (18%). Significant complications occurred exclusively with FPEGJ, including one gastrocolic fistula and 10 buried bumpers.
CONCLUSION: FPEGJ was the preferred primary tube for smaller infants, requires fewer routine changes but had significant complications. Primary BGJ insertion may reduce morbidity without increasing tube displacement risk. Innovation is needed to improve BGJ longevity and suitability for infants.
Journal
Pediatric Surgery International