[Treatment of congenital hypertrophic pyloric stenosis with endoscopic pyloromyotomy]

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Published on: August 11, 2023

You-xiang Zhang1, Yu-qiang Nie, Xue Xiao

  • 1Department of Pediatrics, the First People's Hospital of Guangzhou, Guangzhou 510180, China.

Zhonghua Er Ke Za Zhi = Chinese Journal of Pediatrics
|December 23, 2008
PubMed

Insights

Endoscopic pylorotomy effectively treated congenital hypertrophic pyloric stenosis in infants, enabling rapid feeding and avoiding open surgery. This safe, simple procedure showed significant symptom improvement and good long-term outcomes.

Area of Science:

  • Pediatric Surgery
  • Gastroenterology
  • Minimally Invasive Procedures

Background:

  • Congenital hypertrophic pyloric stenosis (CHPS) presents with significant infant feeding difficulties.
  • Diagnosis relies on clinical signs, ultrasound, and gastrointestinal imaging.
  • Associated conditions like malnutrition and metabolic alkalosis are common.

Purpose of the Study:

  • To assess the efficacy and safety of endoscopic pyloromyotomy for treating CHPS.
  • To evaluate the procedure's impact on infant feeding and recovery.
  • To compare endoscopic approach with traditional surgical methods.

Main Methods:

  • Nine infants diagnosed with CHPS underwent endoscopic pyloromyotomy.
  • The procedure involved gastroscope insertion and precise muscle incisions using specialized endoscopic tools.
  • Incision depth was guided by pre-operative ultrasound measurements.

Main Results:

  • Successful endoscopic passage post-procedure confirmed by imaging.
  • Rapid resumption of feeding within 2-10 hours post-operation.
  • Significant reduction in vomiting, with complete resolution in most infants.
  • No major complications like perforation or hemorrhage were reported.
  • Eight infants showed positive outcomes at follow-up; one case required a repeat procedure.

Conclusions:

  • Endoscopic pyloromyotomy is a safe and effective treatment for CHPS.
  • The minimally invasive approach facilitates early feeding and avoids open surgery.
  • This technique offers a simpler, advantageous alternative for CHPS management.
Abstract

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