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Background <p>Infantile hypertrophic pyloric stenosis (IHPS) is traditionally managed with open Ramstedt pyloromyotomy; laparoscopic pyloromyotomy has become the preferred minimally invasive standard. Endoscopic pyloromyotomy (gastric peroral endoscopic myotomy [G-POEM] or peroral pyloromyotomy [POP]) is an emerging investigational technique. This scoping review maps the available evidence on endoscopic pyloromyotomy for IHPS, characterizes the current evidence base, identifies critical knowledge gaps, and defines priorities for future research.</p> Methods <p>This scoping review followed PRISMA-ScR guidelines. Studies involving infants younger than 6 months with primary IHPS undergoing endoscopic pyloromyotomy were eligible. All study designs were included. Outcomes of interest were efficacy (symptom resolution, time to full feeding, recurrence), safety (complications, operative time, length of stay), and additional outcomes (cosmesis, cost, parental satisfaction). Data were narratively synthesized.</p> Results <p>Seven records (2005–2024) met inclusion criteria: three case reports, two case series, one multicenter retrospective cohort, and one surgical technique chapter, originating from China (<i>n</i> = 4), USA, Russia, and Japan. A total of 43 infants underwent endoscopic pyloromyotomy. Symptom resolution was achieved in 89–100% of cases. Minor complications included mucosal injury and pneumoperitoneum; no major adverse events or mortality were reported. Importantly, two early studies used conscious sedation rather than general anesthesia inconsistent with current infant procedural standards. No study provided comparative data against laparoscopic or open pyloromyotomy.</p> Conclusions <p>Endoscopic pyloromyotomy appears technically feasible in highly specialized centers. However, evidence is limited to early-phase descriptive studies with small sample sizes, no controlled comparisons against laparoscopic pyloromyotomy (the current standard of care), and important concerns regarding anesthesia practices in earlier reports. This technique should remain investigational. Multicenter registries, standardized outcome reporting, and prospective comparative studies against laparoscopic pyloromyotomy are required before broader adoption can be considered.</p>

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Endoscopic Pyloromyotomy for Infantile Hypertrophic Pyloric Stenosis: A Scoping Review of Current Evidence and Future Research Directions

  • 期刊论文

  • 发表日期：

    2026年6月27日

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  • Rida Shakeel,
  • Ammad Uddin,
  • Tuba Basit,
  • Sohaib Aftab Ahmad Chaudhry,
  • Huzaifa Sabir Nawaz,
  • Syeda Masooma Jafri,
  • Amal Tahir,
  • Muhammad Hamza,
  • Ahmed Anwaar Uddin,
  • Aizaz Anwar Khalid

摘要

Background

Infantile hypertrophic pyloric stenosis (IHPS) is traditionally managed with open Ramstedt pyloromyotomy; laparoscopic pyloromyotomy has become the preferred minimally invasive standard. Endoscopic pyloromyotomy (gastric peroral endoscopic myotomy [G-POEM] or peroral pyloromyotomy [POP]) is an emerging investigational technique. This scoping review maps the available evidence on endoscopic pyloromyotomy for IHPS, characterizes the current evidence base, identifies critical knowledge gaps, and defines priorities for future research.

Methods

This scoping review followed PRISMA-ScR guidelines. Studies involving infants younger than 6 months with primary IHPS undergoing endoscopic pyloromyotomy were eligible. All study designs were included. Outcomes of interest were efficacy (symptom resolution, time to full feeding, recurrence), safety (complications, operative time, length of stay), and additional outcomes (cosmesis, cost, parental satisfaction). Data were narratively synthesized.

Results

Seven records (2005–2024) met inclusion criteria: three case reports, two case series, one multicenter retrospective cohort, and one surgical technique chapter, originating from China (n = 4), USA, Russia, and Japan. A total of 43 infants underwent endoscopic pyloromyotomy. Symptom resolution was achieved in 89–100% of cases. Minor complications included mucosal injury and pneumoperitoneum; no major adverse events or mortality were reported. Importantly, two early studies used conscious sedation rather than general anesthesia inconsistent with current infant procedural standards. No study provided comparative data against laparoscopic or open pyloromyotomy.

Conclusions

Endoscopic pyloromyotomy appears technically feasible in highly specialized centers. However, evidence is limited to early-phase descriptive studies with small sample sizes, no controlled comparisons against laparoscopic pyloromyotomy (the current standard of care), and important concerns regarding anesthesia practices in earlier reports. This technique should remain investigational. Multicenter registries, standardized outcome reporting, and prospective comparative studies against laparoscopic pyloromyotomy are required before broader adoption can be considered.