G-POEM safe, effective for infants with congenital hypertrophic pyloric stenosis

Treatment with the minimally invasive gastric peroral endoscopic pyloromyotomy (G-POEM) is not only safe and feasible but also effective for infants with congenital hypertrophic pyloric stenosis (CHPS), according to a recent study, noting acceptable clinical response in the short term.

A group of researchers reviewed data from 21 patients treated with G-POEM at three tertiary children’s endoscopic centres in China between January 2019 and December 2020. They then summarized clinical characteristics, procedure-related parameters, perioperative management, and follow-up outcomes.

All patients who underwent G-POEM had a successful operation, with a median duration of 49 minutes. Submucosal tunnels were successfully established along the greater curvature of the stomach in 19 patients. However, due to difficulty, two cases were switched to the lesser curvature of the stomach.

Perioperative major adverse events did not occur, but minor ones did, including inconsequential mucosal injury in five patients and unsatisfactory closure of the mucosal incision in one.

On postoperative day 3, all patients demonstrated smooth passage of the contrast agent through the pylorus in upper gastrointestinal contrast radiography. The growth curves achieved normal levels at 3 months postprocedure.

Notably, recurrent clinical symptoms did not occur in any patient during the median 25.5 months follow-up period.

“Further multicentre studies should be performed to compare the long-term outcomes of this minimally invasive technique with open or laparoscopic pyloromyotomy,” the researchers said.

CHPS is a common infantile disease that requires surgical intervention and is normally treated with open or laparoscopic pyloromyotomy. G-POEM has been used recently for adult gastroparesis.