Inbal Golan-Tripto1,2,3, Dina Weinstein Mezan4, Sergey Tsaregorodtsev5, Liran Stiler-Timor6, Yotam Dizitzer7, Aviv Goldbart8,9,4, Micha Aviram9,4. 1. Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel. inbalgt@clalit.org.il. 2. Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel. inbalgt@clalit.org.il. 3. Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 151, Beer Sheva, Israel. inbalgt@clalit.org.il. 4. Faculty of Health Sciences, Ben-Gurion University of the Negev, PO Box 151, Beer Sheva, Israel. 5. Department of Anesthesia and Critical Care, Soroka University Medical Center, Beer Sheva, Israel. 6. Department of ENT Surgery, Soroka University Medical Center, Beer Sheva, Israel. 7. Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel. 8. Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel. 9. Pediatric Pulmonary Unit, Soroka University Medical Center, Beer Sheva, Israel.
Abstract
Rigid bronchoscopy is the procedure of choice for removal of inhaled foreign bodies. In this retrospective study, we assessed the safety and efficacy of flexible bronchoscopy use in the removal of inhaled foreign bodies in children. One hundred eighty-two patients (median age of 24 months, 58% males) underwent an interventional bronchoscopy for the removal of inhaled foreign body between 2009 and 2019, 40 (22%) by flexible, and 142 (78%) by rigid bronchoscopy. 88.73% of rigid and 95% of flexible bronchoscopies were successful in foreign bodies removal (p value = 0.24). Complication rate was higher among rigid bronchoscopy (9.2% vs. 0%, p = 0.047). From 2017 onwards, following the implementation of flexible bronchoscopy for foreign bodies removal, 64 procedures were performed, 33 (51.6%) flexible, and 31 (48.4%) rigid. Procedure length was shorter via flexible bronchoscopy (42 vs 58 min, p = 0.016). Length of hospital stay was similar. Conclusion: In our hands, flexible bronchoscopy is an efficient and safe method for removal of inhaled foreign bodies in children, with shorter procedure time and minimal complication rate. Flexible bronchoscopy could be considered as the procedure of choice for removal of inhaled foreign bodies in children, by an experienced multidisciplinary team. What is Known: • Rigid bronchoscopy is currently the gold standard for removal of inhaled foreign bodies in children. • Rigid bronchoscopy has a relatively high complication rate compared to flexible bronchoscopy. What is New: • Flexible bronchoscopy is a short, safe, and efficient procedure to remove inhaled foreign bodies in children, compared to rigid bronchoscopy. • Flexible bronchoscopy could be proposed as the procedure of choice for removal of inhaled foreign bodies in children, if an experienced operator is available.
Rigid bronchoscopy is the procedure of choice for removal of inhaled foreign bodies. In this retrospective study, we assessed the safety and efficacy of flexible bronchoscopy use in the removal of inhaled foreign bodies in children. One hundred eighty-two patients (median age of 24 months, 58% males) underwent an interventional bronchoscopy for the removal of inhaled foreign body between 2009 and 2019, 40 (22%) by flexible, and 142 (78%) by rigid bronchoscopy. 88.73% of rigid and 95% of flexible bronchoscopies were successful in foreign bodies removal (p value = 0.24). Complication rate was higher among rigid bronchoscopy (9.2% vs. 0%, p = 0.047). From 2017 onwards, following the implementation of flexible bronchoscopy for foreign bodies removal, 64 procedures were performed, 33 (51.6%) flexible, and 31 (48.4%) rigid. Procedure length was shorter via flexible bronchoscopy (42 vs 58 min, p = 0.016). Length of hospital stay was similar. Conclusion: In our hands, flexible bronchoscopy is an efficient and safe method for removal of inhaled foreign bodies in children, with shorter procedure time and minimal complication rate. Flexible bronchoscopy could be considered as the procedure of choice for removal of inhaled foreign bodies in children, by an experienced multidisciplinary team. What is Known: • Rigid bronchoscopy is currently the gold standard for removal of inhaled foreign bodies in children. • Rigid bronchoscopy has a relatively high complication rate compared to flexible bronchoscopy. What is New: • Flexible bronchoscopy is a short, safe, and efficient procedure to remove inhaled foreign bodies in children, compared to rigid bronchoscopy. • Flexible bronchoscopy could be proposed as the procedure of choice for removal of inhaled foreign bodies in children, if an experienced operator is available.
Authors: N Facciolongo; M Patelli; S Gasparini; L Lazzari Agli; M Salio; C Simonassi; B Del Prato; P Zanoni Journal: Monaldi Arch Chest Dis Date: 2009-03