Feeding Jejunostomy for Enteral Nutrition in Complicated Esophageal Atresia: Management of Anastomotic Leak and Staged Repair: A Single-Center Experience

Purpose: To evaluate the feasibility, safety, and nutritional outcomes of feeding jejunostomy (FJ) in neonates with esophageal atresia (EA) complicated by anastomotic leak (AL) or requiring staged repair. Methods: We retrospectively reviewed 41 neonates who underwent EA/tracheoesophageal fistula repair (2018–2023). Seven (17%) developed AL. Their nutritional management and outcomes are described. Results: FJ was placed in 10 patients: 6 for AL (3 primary, 3 after failed TPN), 3 for staged repair, and 1 for dysphagia.In the 6 AL patients managed with FJ, full enteral feeding was established within 72 hours. Radiologic leak closure occurred at a median of 9 days (range 7–13) after FJ placement. No major procedure-related complications occurred. Four patients initially managed with TPN (3 referred with persistent leak) had prolonged leakage (mean 30 days) and developed sepsis or cholestasis; 3 were converted to FJ. Conclusion: FJ is technically feasible and safe in selected neonates with complicated EA. It enables reliable enteral nutrition during anastomotic healing. Comparative effectiveness requires prospective multicenter study.