Related Experiment Video

Updated: Jul 17, 2026

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis
03:57

Transmesenteric Laparoscopic Pyeloplasty in Trendelenburg Position for Horseshoe Kidney with Hydronephrosis

Published on: July 8, 2025

Streamlining the care of patients with hypertrophic pyloric stenosis: application of a clinical pathway

M P Michalsky1, D Pratt, D A Caniano

  • 1Division of Pediatric Surgery, Department of Surgery, The Ohio State University College of Medicine and Public Health and Children's Hospital, Columbus, OH 43205, USA.

Journal of Pediatric Surgery
|June 22, 2002
PubMed

Insights

Implementing a clinical pathway for hypertrophic pyloric stenosis (HPS) significantly reduced hospital stays and costs for infants. This improvement was driven by faster postoperative oral feeding resumption and earlier discharge.

Area of Science:

  • Pediatric Surgery
  • Healthcare Management
  • Clinical Pathway Implementation

Background:

  • Hypertrophic pyloric stenosis (HPS) is a common surgical condition in infants.
  • Variability in clinical practice can impact patient outcomes and healthcare costs.

Purpose of the Study:

  • To assess the effect of a clinical pathway on infants diagnosed with hypertrophic pyloric stenosis (HPS).
  • To evaluate changes in length of stay, hospital charges, and patient outcomes post-pathway implementation.

Main Methods:

  • Retrospective analysis of 83 infants with HPS, comparing pre-pathway (n=40) and post-pathway (n=43) groups.
  • Key metrics analyzed included time to first feeding, discharge time, total length of stay, hospital charges, and complications.

Main Results:

  • No significant difference in preoperative stay or admission metabolic status.
  • Post-pathway infants showed significantly faster resumption of oral feedings (4.6 vs 7.5 hours) and earlier discharge (26.7 vs 38.0 hours).
  • This led to a reduced total length of stay (41.8 vs 57.8 hours) and lower hospital charges ($4,555 vs $5,400).

Conclusions:

  • Clinical pathways for HPS effectively reduce practice variability.
  • This standardization significantly shortens hospital stay and decreases associated costs.
  • The primary driver of these improvements is the accelerated postoperative return to oral feeding.
Abstract

More Related Videos

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy10:09

Application of Simplified Stent-bridging Pancreaticogastrostomy in Open Pancreaticoduodenectomy

Published on: March 17, 2026

Related Concept Videos

Methods of Documentation VI: Case Management Model01:15

Methods of Documentation VI: Case Management Model

The case management model is a multidisciplinary approach that involves healthcare professionals from diverse disciplines, such as physicians, nurses, therapists, social workers, and pharmacists, working collaboratively to address the various needs of patients. Each healthcare professional brings unique expertise and perspectives, contributing to a more comprehensive understanding of the patient's condition and tailoring treatment plans accordingly.
For example, a patient with a chronic illness...
Esophageal Strictures-II: Clinical Features and Management01:26

Esophageal Strictures-II: Clinical Features and Management

Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Peptic Ulcer Disease V: Surgical Management and Nursing Care01:25

Peptic Ulcer Disease V: Surgical Management and Nursing Care

Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Cardiomyopathy III: Hypertrophic Cardiomyopathy01:29

Cardiomyopathy III: Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
Cardiomyopathy V: Interprofessional Care01:29

Cardiomyopathy V: Interprofessional Care

Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
Cardiomyopathy VII: Pre and Post Operative Nursing Management01:28

Cardiomyopathy VII: Pre and Post Operative Nursing Management

Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...