Purpose or Case Report: Gastro-Jejunostomy (GJ) tubes are commonly placed and exchanged by interventional radiologists (IR) in pediatric patients requiring transpyloric feeds. GJ tubes with slight variations are available from different manufacturers, most frequently used are Avanos Medical, Inc. (previously Halyard Medical Devices) and Applied Medical Technology (AMT). There is currently no published data available comparing complication rates between the different GJ tubes. The goal of this study is to compare complication rates at two different pediatric institutions and reasons for non-elective required exchange/replacement of GJ tubes manufactured by Avanos and AMT in pediatric patients.
Methods & Materials: A retrospective review on GJ tubes placed by IR at two tertiary pediatric hospitals between 1/12009 and 8/302019, on patients /aged one month to 22 years. Data on patient demographics, GJ tube specification, placement information, reason for replacement, and complication rates related to the procedure were collected and analyzed. Analysis utilizing Chi square test were performed.
Results: A total of 4,646 GJ tube placements were evaluated on 895 (Site 1 n=415, Site 2 n=435) subjects. One-third of the placements were manufactured by Avanos (n=1657, 36%) and a quarter utilized AMT (n=1188, 26%). Modified tubes and tubes from other manufacturers were excluded yielding a total number of 2,845 GJ tube placements. One-third of placements were routine elective exchanges (n=986, 35%), followed by non-elective exchanges/replacements (n=1859, 65%) for leaking (including around and through the tube) (n=268, 9%) and occlusion (n=217, 8%) for both manufacturers. There were equal numbers of complicating factors requiring non-elective replacement between Avanos (n=1075, 65%) and AMT (n=784, 66%). However, in evaluating the most common factors, there was a statistically significant higher rate of leaking (n=268) in Avanos (n=194, 12%) compared to AMT (n=74, 6%) (p=<0.001). Occlusion rates (n=217) were also statistically higher in Avanos (n=150, 9%) as compared to AMT (n=67, 6%) (p=<0.001). Balloon ruptures (n=115) were not statistically different between manufacturers, Avanos (n=54, 3%) and AMT (n=61, 5%) (p=0.012).
Conclusions: While routine elective change is a common reason for GJ tube exchange, two-thirds of patients have various factors requiring a non-elective exchange/replacement regardless of manufacturer with a statistically higher rate of leaking and occlusion in GJ tubes manufactured by Avanos versus AMT.