Background: Definitive surgical care is often delayed in hypertrophic pyloric stenosis (HPS). Our aim is to evaluate the effect modifiable factors in preoperative HPS management have on efficiency of care.
Methods: A retrospective review of all patients undergoing pyloromyotomy for HPS at two US children's hospitals between 2008 and 2018 was performed.
Results: 406 patients were included in the study. The majority (310, 76 %) were adequately resuscitated and ready for surgery upon diagnosis in the ER. However, only 133 patients (43 %) had surgery on the day of admission. Patients diagnosed between 12pm and 6pm were more likely to have surgery the next day than those diagnosed before noon (67 % vs 33 %, p < .001), which correlated with a longer length of stay (32 vs 47 h, p < .001).
Conclusion: The majority of patients presenting with HPS can safely undergo same day surgery. Delaying surgery due to an afternoon diagnosis is common, and leads to a modifiable increased total length of stay.
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| http://dx.doi.org/10.1016/j.amjsurg.2024.01.013 | DOI Listing |
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Article Synopsis
- The study aimed to assess the long-term gastrointestinal effects of pyloromyotomy in children who had undergone this surgery for infantile hypertrophic pyloric stenosis (IHPS) from 2007 to 2017.
- A questionnaire, including the Pediatric Quality of Life Inventory™ Gastrointestinal symptoms module, was completed by 199 participants, revealing that their GI symptoms scores were similar to those of healthy peers.
- The results suggest that long-term GI issues after pyloromyotomy are rare, indicating no significant difference in health outcomes between these children and healthy controls, which can help inform parents and lessen the need for extensive follow-up care.
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