Therapeutic Effect of Esophageal Foreign Body Extraction Management: Flexible versus Rigid Endoscopy in 216 Adults of Beijing

Yan, Xin; Zhou, Liya; Lin, Sanren; Wang, Ye; Wang, Yingchun

doi:10.12659/msm.889758

Cited by 20 publications

(5 citation statements)

References 28 publications

(24 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, excluding the article by Wang. [ 48 ], there was no heterogeneity ( I 2 = 0.0%, τ 2 = 0.0%). This indicates that minor complications, such as mucosal edema and erosions, were not considered relevant in other studies.…”

Section: Discussionmentioning

confidence: 97%

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

et al. 2018

View full text Add to dashboard Cite

BackgroundForeign body (FB) impaction accounts for 4% of emergency endoscopies in clinical practice. Flexible endoscopy (FE) is recommended as the first-line therapeutic option because it can be performed under sedation, is cost-effective, and is well tolerated. Rigid endoscopy (RE) under general anesthesia is less used but may be advantageous in some circumstances. The aim of the study was to compare the efficacy and safety of FE and RE in esophageal FB removal.MethodsPubMed, MEDLINE, Embase, and Cochrane databases were consulted matching the terms “Rigid endoscopy AND Flexible endoscopy AND foreign bod*”. Pooled effect measures were calculated using an inverse-variance weighted or Mantel-Haenszel in random effects meta-analysis. Heterogeneity was evaluated using I2 index and Cochrane Q test.ResultsFive observational cohort studies, published between 1993 and 2015, matched the inclusion criteria. One thousand four hundred and two patients were included; FE was performed in 736 patients and RE in 666. Overall, 101 (7.2%) complications occurred. The most frequent complications were mucosal erosion (26.7%), mucosal edema (18.8%), and iatrogenic esophageal perforations (10.9%). Compared to FE, the estimated RE pooled success OR was 1.00 (95% CI 0.48–2.06; p = 1.00). The pooled OR of iatrogenic perforation, other complications, and overall complications were 2.87 (95% CI 0.96–8.61; p = 0.06), 1.09 (95% CI 0.38–3.18; p = 0.87), and 1.50 (95% CI 0.53–4.25; p = 0.44), respectively. There was no mortality.ConclusionsFE and RE are equally safe and effective for the removal of esophageal FB. To provide a tailored or crossover approach, patients should be managed in multidisciplinary centers where expertise in RE is also available. Formal training and certification in RE should probably be re-evaluated.

show abstract

Section: Discussionmentioning

confidence: 97%

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

et al. 2018

View full text Add to dashboard Cite

show abstract

“…A comparative study between flexible and rigid endoscopy has shown that the former has better results in terms of postoperative comfort and dysphagia (15% vs. 48%; p < 0.0001) [ 35 ]. The results in terms of successful rate of FB retrieval are similar between flexible endoscopy and rigid endoscopy, though the former carries a higher rate of minor complications, while the latter has a higher rate of perforation (0.0% vs. 3.2% p < 0.002) [ 36 , 37 ]. A meta-analysis comparing flexible versus rigid endoscopy for retrieval of upper esophageal FB showed that both were effective and safe, with similar success and overall complication rates ( p < 0.06) [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Dental Prosthesis in Esophagus: A Right Cervicotomic Approach

Zanchetta

Monti

Latham

et al. 2022

Life

View full text Add to dashboard Cite

Foreign body ingestion in the upper digestive tract is a relatively common emergency. Less than 1% have to be treated surgically. We report the case of a 68-year-old man who ingested a dental prosthesis, probably during a seizure, and thus unknowingly, and presented two days later to the emergency department complaining of a mild dysphagia. A chest radiograph showed the presence of a removable dental prosthesis in the upper esophageal tract. The patient was brought to the operating room where a multidisciplinary equipe was assembled. Two attempts of retrieval with a flexible and a rigid endoscope failed because the removable dental prosthesis was stuck in the right pyriform sinus. Therefore, the surgeon performed an uncommon right cervicotomy and retrieved the foreign body through a right-side esophagotomy. The surgical approach depends on the nature and location of the foreign body. Urgent treatment is required whenever the patient develops dyspnea or dysphagia because of the high risk of inhalation and asphyxia. Removal of any esophageal foreign body has to be performed within 12–24 h. Repeated attempts to retrieve large dental prosthesis using an endoscope may result in esophageal perforation therefore when such risk of complication is too high, a surgical approach becomes inevitable. In our opinion, surgery remains the extrema ratio after a failed endoscopic retrieval attempt but can be lifesaving despite high risk of complications.

show abstract

“…Take China, for example, the most common type of FB is fish bones in south China and coastal provinces, in contrast with jujube pits in north China. 9,26 This may be explained by the following reasons. First of all, north China is the main place of origin of jujubes, while fish are daily diet in south China and coastal provinces with an abundant supply.…”

Section: Discussionmentioning

confidence: 99%

“…This makes RE widely used unnecessarily. 8,9 Furthermore, ingested FB could be classified into certain types according to their features, including food bolus, blunt objects, sharp-pointed objects, long objects, and special objects (ie, magnets, coins, and disk batteries). 2,3,7,[10][11][12] Most previous researches have studied them together, although the clinical characteristics and management differ greatly from each other.…”

Section: Introductionmentioning

confidence: 99%

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

et al. 2020

View full text Add to dashboard Cite

Objectives: To propose a management algorithm for adult patients with sharp-pointed esophageal foreign-body impaction (EFBI) who have rigid endoscopy (RE) indications and to conduct a retrospective analysis of their data. Methods: All adult patients who received RE at the Department of Otorhinolaryngology in Beijing Shijitan Hospital between January 2017 and May 2019 were enrolled. The demographics, clinical characteristics, and management data were collected and analyzed. Results: A total of 130 patients were identified, 56.9% were female with median age 60 years. More than half (56.9%) of patients had foreignbody (FB) ingestion on holidays. The most frequent FBs were jujube pits (66.9%) and bones (23.8%). There is a significant female predominance in ingestion of jujube pits (65.5%, P ¼ .005). The most common symptoms were odynophagia (49.2%) and sore throat (47.7%). The majority (96.8%) of FB founded were lodged at upper esophagus. In all, 74 patients were categorized as having mild complications and 54 having significant complications. Time interval from ingestion to presentation longer than 15 hours was an independent risk factor for significant complications, while esophagogram with barium as a protective factor. Conclusions: Long-time interval from ingestion to presentation will lead to high risk of significant complications. Computed tomography should be a prioritized imaging method for all patients suspected with EFBI, and multidisciplinary collaboration is recommended. Besides, mass education on eating habits is necessary.

show abstract

Therapeutic Effect of Esophageal Foreign Body Extraction Management: Flexible versus Rigid Endoscopy in 216 Adults of Beijing

Cited by 20 publications

References 28 publications

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

Flexible versus rigid endoscopy in the management of esophageal foreign body impaction: systematic review and meta-analysis

Dental Prosthesis in Esophagus: A Right Cervicotomic Approach

Management of Sharp-Pointed Esophageal Foreign-Body Impaction With Rigid Endoscopy: A Retrospective Study of 130 Adult Patients

Contact Info

Product

Resources

About