Review for 10.1186/s12876-021-01679-8 (2021)

Reviewer’s report
Title: 
Outcomes and survival of infants with congenital duodenal obstruction
following Kimura procedure with post-anastomosis jejunostomy feeding tube
Version: 
1 
Date: 
02 Sep 2020
Reviewer's report:
The authors conducted a retrospective study to analyze whether patients after
Kimura procedure can benefit from a jejunal feeding tube.
They concluded that time to full oral feeding is reduced and duration of
parenteral nutrition is shorter in patients with a jejunal feeding tube after Kimura
procedure for duodenal obstruction.
Following points need further attention:
MAJOR REMARKS
As described by antecedent reviewers, the heterogeneity of the population in
combination with the low numbers is the main problem of this study. This was
already addressed by a separate analysis for male and female patients. However,
this might be problematic due to even lower numbers (table 4, please indicate
N).
Furthermore, patients without congenital anomaly received a JFT twice as much
as patients with congenital anomaly (9/23 vs 6/29). This reduced load of
comorbidities could be responsible for the better outcome in the JFT group. Can
the authors comment on that?
Similarly, more clinical signs in the Non JFT could reflect advanced disease
which could similarly be responsible for a worse outcome in this group. This
goes in line with a higher age at time of surgery in this group.
Having these limitations in mind, this series is important, as no better data exist
at the moment. With adequate discussion of the above mentioned points, this
data is important as long as no randomized trial answers this question.
MINOR REMARKS
- Can the authors comment on the death rate close to 40%, is this number
comparable to similar series?
- Early enteral feeding is to be expected in the JFT group, I would personally not
mention this as a primary result
- As far as I am aware, exact location and technique for placement of the JFT is
not mentioned, this might be interesting for readers
- L163: decreasing the possibility of intestinal adhesions: very hypothetical,
mechanism?
- Professional language editing is recommended.
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Is the study design appropriate to answer the research question (including the use
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