Removal of tracheobronchial foreign bodies in adults using flexible bronchoscopy: experience 1995–2006

Abstract

Although foreign bodies in the tracheobronchial tree are rare in adults, the clinician must be aware of their likelihood. Foreign body aspiration should be considered especially in the etiology of recurrent lung diseases and in the presence of risk factors for aspiration, in particular with different neurologic and neuromuscular diseases. They can be successfully and safely removed in the majority of patients under local anesthesia by using FBSC. In cases when repeated procedure is needed, endotracheal tube is recommended.

Removal of Tracheobronchial Foreign Bodies in Adults Using a Flexible Bronchoscope: Experience with 200 Cases in China

“…The present study consisted of 200 adult Chinese patients with FBs who were treated in the past 10 years. The age and sex distributions were similar to those in the previous studies (3,(5)(6)(7)(8)(9)(10).…”

“…Several studies in Europe explored the risk factors for FB aspiration in adults, and suggested that populations with various neurological and neuromuscular diseases, as well as head trauma and alcohol abuse, may have a higher risk of FB aspiration (3,11). However, in our study, few of FB aspirations occurred in such patients, and most were in previously healthy adults.…”

“…Furthermore, the latter was not universally used in many centers in China because of its relatively high requirements for instruments and skills, although the use of rigid bronchoscopy was one of the major procedures used for foreign body removal in a previous study (16). Our experience showed that the success rate using flexible bronchoscopy for removal of FBs was 96.5%, which was one of the highest success rates that has been reported when only flexible bronchoscopy was utilized (3,(5)(6)(7). During the removal of FBs, endoscopists should operate the instrument carefully to prevent the mucous membrane from being injured by sharp FBs.…”

“…However, a history of FB aspiration might not be obvious, and the related symptoms, such as chronic cough, dyspnea and hemoptysis for most adult patients could remain unnoticed for months to years (1,2). The delayed diagnosis of FBs may lead to serious complications such as granulation formation, recurrent pneumonia, atelectasis and endobronchial stenotic scarring (3)(4)(5). As a result, successfully extracting the FB is not the end of the story for adult patients.…”

“…The extraction of FBs using a flexible bronchoscope is one of the most commonly used techniques (3,6,7). A few published studies have described the clinical features and endoscopic management of tracheobronchial FBs (2,3,(5)(6)(7)(8)(9)(10). However, the sample sizes of these studies were small, and few of them reported the management of the complications of FBs aspiration.…”