{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:51:22Z","timestamp":1792093882103,"version":"4.4.0"},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:00:00Z","timestamp":1792022400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Surg Int"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Building on our previous work demonstrating that balloon-retained gastro-jejunostomy tubes (BGJ) avoid complications unique to disc-retained devices but require more frequent replacement, we evaluated caregiver experience and healthcare resource use to better inform tube selection in children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Families whose children had experienced both Freka\u00ae percutaneous endoscopic gastro-jejunostomy (FPEGJ) and BGJ completed a paired questionnaire assessing nine experience domains (0\u20135 Likert-type scales) with free-text comments. Scores were compared using the Wilcoxon signed-rank test and comments underwent thematic analysis. A 24-month NHS resource-use model compared staged FPEGJ followed by planned BGJ conversion with primary laparoscopic BGJ insertion using 2026\/27 NHS Payment Scheme tariffs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twelve of thirteen eligible families responded(92.3%). Nine(75%) preferred BGJ and three had no preference. No questionnaire domain differed significantly, although BGJ showed trends towards greater comfort and easier daily care, while FPEGJ showed a trend towards less leakage. Families favoured BGJ because of its lower profile, avoidance of general anaesthesia (GA) for replacement and avoidance of buried bumper syndrome. Standard staged FPEGJ treatment cost \u00a34,192 over 24 months compared with \u00a36,024 for primary laparoscopic BGJ, saving \u00a31,831(30.4%). Even with laparoscopic assistance, FPEGJ remained 22.1% less expensive. Routine BGJ exchanges were the principal cost driver.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A staged FPEGJ-to-BGJ strategy appears to provide the best balance between caregiver experience and NHS resource use. However, disc-retained devices commit children to at least one future GA, the associated burden of which is not fully captured by cost analysis. BGJ with reliable 12-month durability may further reduce procedural burden and healthcare costs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00383-026-06680-4","type":"journal-article","created":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:39:03Z","timestamp":1792093143000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Patient experience and resource use analysis of balloon-retained vs. disc-retained gastro-jejunal tubes in children"],"prefix":"10.1007","volume":"42","author":[{"given":"Muhammad Saad","family":"Ali","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saifullah","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olugbenga Michael","family":"Aworanti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,15]]},"reference":[{"key":"6680_CR1","doi-asserted-by":"publisher","first-page":"707","DOI":"10.1016\/J.JPEDSURG.2015.02.020","volume":"50","author":"MH Livingston","year":"2015","unstructured":"Livingston MH, Shawyer AC, Rosenbaum PL et al (2015) Fundoplication and gastrostomy versus percutaneous gastrojejunostomy for gastroesophageal reflux in children with neurologic impairment: A systematic review and meta-analysis. J Pediatr Surg 50:707\u2013714. https:\/\/doi.org\/10.1016\/J.JPEDSURG.2015.02.020","journal-title":"J Pediatr Surg"},{"key":"6680_CR2","unstructured":"Association for Paediatric Palliative Medicine (APPM) Management of gastrointestinal dystonia in children and young people with severe neurological impairment in the palliative care setting [Internet]. Bristol (UK): APPM; 2023 [cited 2025 Sep 25]. Available from: https:\/\/www.appm.org.uk\/_webedit\/uploaded-files\/All%20Files\/Clinical%20guidelines\/GI%20dystonia%20guidelines.pdf"},{"key":"6680_CR3","doi-asserted-by":"publisher","DOI":"10.1007\/S00383-026-06378-7","author":"M Naeem","year":"2026","unstructured":"Naeem M, Ali MS, Khan S et al (2026) Comparative analysis of balloon vs solid internal bumper gastro-jejunal tubes in children: a review of outcomes. Pediatr Surg Int. https:\/\/doi.org\/10.1007\/S00383-026-06378-7","journal-title":"Pediatr Surg Int"},{"key":"6680_CR4","unstructured":"Fresenius Kabi Freka\u00ae jejunal feeding tubes [Internet]. Bad Homburg (Germany): Fresenius Kabi; [cited 2025 Jul 15]. Available from: Fresenius Kabi UK healthcare professional area"},{"key":"6680_CR5","unstructured":"Avanos Medical MIC KEY\u00ae GJ feeding tube kits [Internet]. Alpharetta (GA): Avanos Medical; [cited 2025 Jul 15]. Available from: Avanos product catalog"},{"key":"6680_CR6","unstructured":"Applied Medical Technology Inc G JET\u00ae gastric jejunal tubes [Internet]. Brecksville (OH): AMT; [cited 2025 Jul 15]. Available from: AMT G JET product pages"},{"key":"#cr-split#-6680_CR7.1","unstructured":"NHS England (2025) \/26 NHS Payment Scheme prices workbook [Internet]. London: NHS England"},{"key":"#cr-split#-6680_CR7.2","unstructured":"2025 [cited 2026 May 8]. Available from: https:\/\/www.england.nhs.uk\/wp-content\/uploads\/2025\/04\/25-26NHSPS-prices-pay-award.xlsx"},{"key":"6680_CR8","unstructured":"NHS Supply Chain [Internet], Leeds NHS Supply Chain; cited 2026 May 8. Available from: https:\/\/www.supplychain.nhs.uk"},{"key":"6680_CR9","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1136\/flgastro-2014-100503","volume":"6","author":"JK Dowman","year":"2015","unstructured":"Dowman JK, Ditchburn L, Chapman W et al (2015) Observed high incidence of buried bumper syndrome associated with Freka PEG tubes. Frontline Gastroenterol 6:194\u2013198. https:\/\/doi.org\/10.1136\/flgastro-2014-100503","journal-title":"Frontline Gastroenterol"},{"key":"6680_CR10","doi-asserted-by":"publisher","first-page":"618","DOI":"10.3748\/wjg.v22.i2.618","volume":"22","author":"J Cyrany","year":"2016","unstructured":"Cyrany J, Rejchrt S, Kopacova M, Bures J (2016) Buried bumper syndrome: A complication of percutaneous endoscopic gastrostomy. World J Gastroenterol 22:618\u2013627","journal-title":"World J Gastroenterol"},{"key":"6680_CR11","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1093\/jcag\/gwab002.239","volume":"4","author":"V Avinashi","year":"2021","unstructured":"Avinashi V, Hoang T, Lee E et al (2021) A Review Of 101 Children with Gastro-Jejunal Feeding Tubes Including Their Complications at BC Children\u2019s Hospital. J Can Assoc Gastroenterol 4:296\u2013297","journal-title":"J Can Assoc Gastroenterol"},{"key":"6680_CR12","doi-asserted-by":"publisher","first-page":"412","DOI":"10.1016\/j.jpedsurg.2020.10.012","volume":"56","author":"C Gerall","year":"2021","unstructured":"Gerall C, Mencin AA, DeFazio J et al (2021) Primary gastrojejunostomy tube placement using laparoscopy with endoscopic assistance: a novel technique. J Pediatr Surg 56:412\u2013416. https:\/\/doi.org\/10.1016\/j.jpedsurg.2020.10.012","journal-title":"J Pediatr Surg"},{"key":"6680_CR13","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/j.jss.2019.07.049","volume":"245","author":"RE Wilson","year":"2020","unstructured":"Wilson RE, Rao PK, Cunningham AJ et al (2020) A Natural History of Gastrojejunostomy Tubes in Children. J Surg Res 245:461\u2013466. https:\/\/doi.org\/10.1016\/j.jss.2019.07.049","journal-title":"J Surg Res"},{"issue":"13","key":"6680_CR14","doi-asserted-by":"publisher","first-page":"2492","DOI":"10.1007\/S00247-021-05171-Z","volume":"51","author":"EL Rose","year":"2021","unstructured":"Rose EL, Patel PA (2021) Cost evaluation of two types of gastrojejunal feeding tubes used in pediatric patients. Pediatr Radiol 51(13):2492\u20132497. https:\/\/doi.org\/10.1007\/S00247-021-05171-Z","journal-title":"Pediatr Radiol"},{"key":"6680_CR15","unstructured":"https:\/\/avanos.com.au\/wp-content\/uploads\/2021\/11\/MIC-KEY-Gastric-Jejunal-Patient-Information-Leaflet.pdf"},{"key":"6680_CR16","doi-asserted-by":"publisher","first-page":"426","DOI":"10.1097\/00005176-200404000-00011","volume":"38","author":"L Michaud","year":"2004","unstructured":"Michaud L, Guimber D, Blain-Stregloff AS et al (2004) Longevity of balloon-stabilized skin-level gastrostomy device. J Pediatr Gastroenterol Nutr 38:426\u2013429. https:\/\/doi.org\/10.1097\/00005176-200404000-00011","journal-title":"J Pediatr Gastroenterol Nutr"},{"key":"6680_CR17","unstructured":"Applied Medical Technology (AMT) micro G-JET\u00ae [Internet]. [cited 2025 Sep 24]. Available from: https:\/\/www.appliedmedical.net\/enteral\/micro-g-jet\/"}],"container-title":["Pediatric Surgery International"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06680-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-026-06680-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00383-026-06680-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:39:05Z","timestamp":1792093145000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00383-026-06680-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,15]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["6680"],"URL":"https:\/\/doi.org\/10.1007\/s00383-026-06680-4","relation":{},"ISSN":["1437-9813"],"issn-type":[{"value":"1437-9813","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,15]]},"assertion":[{"value":"4 August 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"5 October 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 October 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing interests.","order":1,"name":"Ethics","label":"Conflict of interest","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"445"}}