Ho-Jun Lee1, Hyun-Soo Kim2, Jin Jeon3, Sang-Hun Park3, Sung-Uk Lim3, Chung-Hwan Jun3, Seon-Young Park3, Chang-Hwan Park3, Sung-Kyu Choi3, Jong-Sun Rew3. 1. Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea. joon8970@hanmail.net. 2. Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea. dshskim@hanmail.net. 3. Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
Abstract
BACKGROUND/AIMS: Most foreign bodies of the upper gastrointestinal tract (UGIT) are successfully removed by endoscopic techniques without complications. However, some require conversion to surgery due to failure of endoscopic removal. The aim of this study was to analyze the risk factors predicting the need to convert to surgery after inability to endoscopically remove the foreign body. PATIENTS AND METHODS: The medical records of 885 patients treated between January 2006 and March 2014 for suspected foreign bodies in the UGIT were retrospectively reviewed. Patient characteristics, the type of foreign bodies, clinical outcomes, and risk factors predicting the conversion to surgery were analyzed. RESULTS: While endoscopic removal was successful in 94.7% (665/702) of the patients, the remaining 5.3% (37/702) needed conversion to surgery. There were no procedure-related deaths. According to the multivariate logistic regression analyses, older age (>70 years, p = 0.004), location (upper esophagus, p = 0.001), larger size (maximal diameter > 30 mm, p = 0.005), and longer impaction time (>40 h, p < 0.001) were significant risk factors predicting conversion to surgery due to inability to remove the foreign body endoscopically. CONCLUSIONS: Most of the foreign bodies in the UGIT were successfully removed by endoscopic techniques. However, surgical removal might need to be considered in patients with age >70 years, and those with foreign bodies in the upper esophagus, maximal diameter >30 mm, and impaction time >40 h, due to the possible high failure rate of endoscopic removal.
BACKGROUND/AIMS: Most foreign bodies of the upper gastrointestinal tract (UGIT) are successfully removed by endoscopic techniques without complications. However, some require conversion to surgery due to failure of endoscopic removal. The aim of this study was to analyze the risk factors predicting the need to convert to surgery after inability to endoscopically remove the foreign body. PATIENTS AND METHODS: The medical records of 885 patients treated between January 2006 and March 2014 for suspected foreign bodies in the UGIT were retrospectively reviewed. Patient characteristics, the type of foreign bodies, clinical outcomes, and risk factors predicting the conversion to surgery were analyzed. RESULTS: While endoscopic removal was successful in 94.7% (665/702) of the patients, the remaining 5.3% (37/702) needed conversion to surgery. There were no procedure-related deaths. According to the multivariate logistic regression analyses, older age (>70 years, p = 0.004), location (upper esophagus, p = 0.001), larger size (maximal diameter > 30 mm, p = 0.005), and longer impaction time (>40 h, p < 0.001) were significant risk factors predicting conversion to surgery due to inability to remove the foreign body endoscopically. CONCLUSIONS: Most of the foreign bodies in the UGIT were successfully removed by endoscopic techniques. However, surgical removal might need to be considered in patients with age >70 years, and those with foreign bodies in the upper esophagus, maximal diameter >30 mm, and impaction time >40 h, due to the possible high failure rate of endoscopic removal.
Authors: Jeong Ho Park; Chang Hwan Park; Jae Hong Park; Soo Jung Lee; Wan Sik Lee; Young Eun Joo; Hyun Soo Kim; Sung Kyu Choi; Jong Sun Rew; Sei Jong Kim Journal: Korean J Gastroenterol Date: 2004-04
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Authors: S Mosca; G Manes; R Martino; L Amitrano; V Bottino; A Bove; A Camera; C De Nucci; G Di Costanzo; M Guardascione; F Lampasi; S Picascia; F P Picciotto; E Riccio; V P Rocco; G Uomo; A Balzano Journal: Endoscopy Date: 2001-08 Impact factor: 10.093