Weighted Tip Extensions Result in Fewer GJ Tube Migrations

To investigate the safety and efficacy of attaching a weighted extension to the distal aspect of prefabricated GJ tubes to determine if this alteration reduces occurrences of tip reflux into the esophagus or stomach.

Materials and Methods:

This retrospective one-way crossover study included 64 GJ tubes in 15 patients placed by multiple operators in the interventional radiology department at a single institution from July 1^st, 2019, to December 1^st, 2021. Patients were selected for a weighted tip extension if they required a GJ tube exchange due to the distal tip refluxing into the stomach or esophagus and were 18 years or older. These modified GJ tubes were prepared by cutting the distal end of a nasojejunal tube to a length of 10-15cm and suturing to the distal aspect of the GJ tube.

Results:

Of the 64 tubes studied, 37 had a weighted tip extension. The unmodified GJ tubes had an average lifespan of 34.3 days, which was significantly shorter compared to the weighted tips (92.8 days, t-test p= 0.001). There was one limited adverse event of abdominal pain and spasms that resolved after exchange with a shorter weighted extension.

Conclusion:

This study suggests that for patients who require a GJ tube replacement due to the tip refluxing proximally into the stomach or esophagus, the addition of a 10-15cm weighted extension to the distal end of the GJ tube is safe and may significantly improve the lifespan of the enteric tube.