A comparison of clinical effects of removing foreign bodies from esophagus by rigid esophagoscope and flexible esophagoscope_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GOU Yunjiu , MA Jilong , HAN Songchen , JIN Dacheng , CHEN Meng , WANG Bing ,  BAI Qizhou

Department of Thoracic Surgery, The Gansu Provincial Hospital, Lanzhou, 730000, P.R.China;

Corresponding?author：

BAI Qizhou, Email: baiqizhou@aliyun.com

Keywords：

Rigid esophagoscopy; flexible esophagoscope; esophageal foreign body; clinical study; case control

DOI：

10.7507/1007-4848.201903045

Video：

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Objective To collect the data of esophageal foreign body patients, and to evaluate the clinical effects of two different surgical methods in our hospital.Methods The clinical data of 294 patients who were treated in Gansu Provincal Hospital from January 2012 to June 2018 were analyzed retrospectively. The clinical data were collected and analyzed by SPSS 22.0. In order to to evaluate the efficacy of flexible esophagoscope (FE) and rigid esophagoscope (RE) in the treatment of esophageal foreign bodies.The patients were divided into two groups: a RE group including 118 patients with 62 males and 56 females at age of 6 (3-37) years and a FE group including 176 patients with 84 males and 92 females at age of 6 (3-59) years.Results There was no significant difference in age, age stratification, gender and foreign body type between the two groups. There was a statistical difference in the initial clinical symptoms (P=0.041) or in esophageal foreign bodies position (P=0.037) between the two groups. The success rate of foreign body removal was similar between the two groups (P=0.632). The success rate was 88.9% (105/118) in the RE group, 87.5% (154/176) in the FE group. The operation time was significantly longer in the RE group than that in the FE group (10.8 ±17.4 min vs. 17.5±21.6 min, P<0.001). The postoperative hospitalization time in the RE groups was longer than that in the FE group (21.5 ±24.2 hours vs. 12.5 ±21.3 hours, P<0.05). There was a statistical difference in the incidence of postoperative complications between the two groups (P=0.034). In the RE group, the main complication was mucosal edema (15.3%). And the rate of bleeding was higher (15.9%) in the FE group. There were 30 patients (25.5%) in the RE group with minor postoperative complications versus the FE group with 40 patients (22.7%); and 1 patient (0.8%) in the RE group with severe complications versus the FE group with 5 paients (2.8%).Conclusion Based on the analysis of this study, it is found that RE has higher safety. But the indications are strict, the professional requirements of the operator and the selection of patients are stronger. The FE is convenient to use, the operation crowd is wide, and the suitable crowd is wide. Therefore, for specific patients, after improving the relevant examination and preoperative evaluation of patients, clinicians need to choose appropriate surgical methods to ensure the success of the operation, and reduce the postoperative complications as far as possible.

Citation： GOU Yunjiu, MA Jilong, HAN Songchen, JIN Dacheng, CHEN Meng, WANG Bing, BAI Qizhou. A comparison of clinical effects of removing foreign bodies from esophagus by rigid esophagoscope and flexible esophagoscope. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2019, 26(12): 1180-1184. doi: 10.7507/1007-4848.201903045 Copy

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2.	Rodríguezhermosa JI, Codinacazador A, Sirvent JM, et al. Surgically treated perforations of the gastrointestinal tract caused by ingested foreign bodies. Colorectal Dis, 2010, 10(7): 701-707.
3.	Chinski A, Foltran F, Gregori D, et al. Foreign bodies in the oesophagus: The experience of the buenos aires paediatric ORL clinic. Int J Pediatr, 2010, 2010(1687-9740): 6.
4.	Kim HJ, Lee OJ, Min HJ, et al. Endoscopic treatment of esophageal foreign bodies in adult: management of 257 cases. Korean J Gastrointest Endosc, 2004, 29(2): 51-57.
5.	王毅, 周本宏. 成人食道異物螺旋CT診斷價值的Meta分析. 職業與健康, 2014, 30(6): 809-814.
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7.	Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr, 2015, 60(4): 562-574.
8.	Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy, 2016, 48(5): 489-496.
9.	ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc, 2011, 73(6): 1085-1091.
10.	王超, 戴天陽, 楊曉燕, 等. 外科途徑治療經保守處理無效的食管異物. 中國胸心血管外科臨床雜志, 2018, 25(6): 539-542.
11.	Athanassiadi K, Gerazounis M, Metaxas E, et al. Management of esophageal foreign bodies: a retrospective review of 400 cases. Eur J Cardiothorac Surg, 2002, 21(4): 653-656.
12.	Little DC, Shah SR, St Peter SD, et al. Esophageal foreign bodies in the pediatric population: our first 500 cases. J Pediatr Surg, 2006, 41(5): 914-918.
13.	Gmeiner D, von Rahden BH, Meco C, et al. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc, 2007, 21(11): 2026-2029.
14.	Berggreen PJ, Harrison E, Sanowski RA, et al. Techniques and complications of esophageal foreign body extraction in children and adults. Gastrointest Endosc, 1993, 39(5): 626.
15.	Macpherson RI, Hill JG, Othersen HB, et al. Esophageal foreign bodies in children: diagnosis, treatment, and complications. Am J Roentgenol, 1996, 166(4): 919.
16.	陳偉東, 陳展勝, 羅育新, 等. 老年食管異物取出術并發癥與麻醉方式的相關性. 河北醫學, 2010, 16(10): 1187-1189.
17.	Zhang X, Zhang X, Tu C, et al. Analysis of the management and risk factors for complications of esophageal foreign body impaction of jujube pits in adults. Wideochir Inne Tech Maloinwazyjne, 2018, 13(2): 250-256.
18.	Yan X, Zhou L, Lin S, et al. Therapeutic effect of esophageal foreign body extraction management: flexible versus rigid endoscopy in 216 adults of Beijing. Med Sci Monit, 2014, 20(20): 2054-2060.
19.	游龍貴, 張克輝, 張小安, 等. 食管異物術后再發頸胸食管周圍膿腫二例分析及處理. 中華耳鼻咽喉頭頸外科雜志, 2016, 51(3): 215-217.
20.	Zhang X, Liu J, Li J, et al. Diagnosis and treatment of 32 cases with aortoesophageal fistula due to esophageal foreign body. Laryngoscope, 2011, 121(2): 267-272.
21.	Kong VY, Sartorius B, Clarke DL. The selective conservative management of penetrating thoracic trauma is still appropriate in the current era. Injury, 2015, 46(1): 49-53.
22.	Srinivasan R, Haywood T, Horwitz B, et al. Role of flexible endoscopy in the evaluation of possible esophageal trauma after penetrating injuries. Am J Gastroenterol, 2000, 95(7): 1725-1729.
23.	Yeh DD, Hwabejire JO, Moya MD, et al. Preoperative evaluation of penetrating esophageal trauma in the current era: An analysis of the National Trauma Data Bank. J Emerg Trauma Shock, 2015, 8(1): 30-33.

1. Cheng W, Tam PK. Foreign-body ingestion in children: experience with 1,265 cases. J Pediatr Surg, 1999, 34(10): 1472-1476.
2. Rodríguezhermosa JI, Codinacazador A, Sirvent JM, et al. Surgically treated perforations of the gastrointestinal tract caused by ingested foreign bodies. Colorectal Dis, 2010, 10(7): 701-707.
3. Chinski A, Foltran F, Gregori D, et al. Foreign bodies in the oesophagus: The experience of the buenos aires paediatric ORL clinic. Int J Pediatr, 2010, 2010(1687-9740): 6.
4. Kim HJ, Lee OJ, Min HJ, et al. Endoscopic treatment of esophageal foreign bodies in adult: management of 257 cases. Korean J Gastrointest Endosc, 2004, 29(2): 51-57.
5. 王毅, 周本宏. 成人食道異物螺旋CT診斷價值的Meta分析. 職業與健康, 2014, 30(6): 809-814.
6. Eisen GM, Baron TH, Dominitz JA, et al. Guideline for the management of ingested foreign bodies. Gastrointest Endosc, 2002, 55(7): 802-806.
7. Kramer RE, Lerner DG, Lin T, et al. Management of ingested foreign bodies in children: a clinical report of the NASPGHAN Endoscopy Committee. J Pediatr Gastroenterol Nutr, 2015, 60(4): 562-574.
8. Birk M, Bauerfeind P, Deprez PH, et al. Removal of foreign bodies in the upper gastrointestinal tract in adults: European Society of Gastrointestinal Endoscopy (ESGE) clinical guideline. Endoscopy, 2016, 48(5): 489-496.
9. ASGE Standards of Practice Committee, Ikenberry SO, Jue TL, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc, 2011, 73(6): 1085-1091.
10. 王超, 戴天陽, 楊曉燕, 等. 外科途徑治療經保守處理無效的食管異物. 中國胸心血管外科臨床雜志, 2018, 25(6): 539-542.
11. Athanassiadi K, Gerazounis M, Metaxas E, et al. Management of esophageal foreign bodies: a retrospective review of 400 cases. Eur J Cardiothorac Surg, 2002, 21(4): 653-656.
12. Little DC, Shah SR, St Peter SD, et al. Esophageal foreign bodies in the pediatric population: our first 500 cases. J Pediatr Surg, 2006, 41(5): 914-918.
13. Gmeiner D, von Rahden BH, Meco C, et al. Flexible versus rigid endoscopy for treatment of foreign body impaction in the esophagus. Surg Endosc, 2007, 21(11): 2026-2029.
14. Berggreen PJ, Harrison E, Sanowski RA, et al. Techniques and complications of esophageal foreign body extraction in children and adults. Gastrointest Endosc, 1993, 39(5): 626.
15. Macpherson RI, Hill JG, Othersen HB, et al. Esophageal foreign bodies in children: diagnosis, treatment, and complications. Am J Roentgenol, 1996, 166(4): 919.
16. 陳偉東, 陳展勝, 羅育新, 等. 老年食管異物取出術并發癥與麻醉方式的相關性. 河北醫學, 2010, 16(10): 1187-1189.
17. Zhang X, Zhang X, Tu C, et al. Analysis of the management and risk factors for complications of esophageal foreign body impaction of jujube pits in adults. Wideochir Inne Tech Maloinwazyjne, 2018, 13(2): 250-256.
18. Yan X, Zhou L, Lin S, et al. Therapeutic effect of esophageal foreign body extraction management: flexible versus rigid endoscopy in 216 adults of Beijing. Med Sci Monit, 2014, 20(20): 2054-2060.
19. 游龍貴, 張克輝, 張小安, 等. 食管異物術后再發頸胸食管周圍膿腫二例分析及處理. 中華耳鼻咽喉頭頸外科雜志, 2016, 51(3): 215-217.
20. Zhang X, Liu J, Li J, et al. Diagnosis and treatment of 32 cases with aortoesophageal fistula due to esophageal foreign body. Laryngoscope, 2011, 121(2): 267-272.
21. Kong VY, Sartorius B, Clarke DL. The selective conservative management of penetrating thoracic trauma is still appropriate in the current era. Injury, 2015, 46(1): 49-53.
22. Srinivasan R, Haywood T, Horwitz B, et al. Role of flexible endoscopy in the evaluation of possible esophageal trauma after penetrating injuries. Am J Gastroenterol, 2000, 95(7): 1725-1729.
23. Yeh DD, Hwabejire JO, Moya MD, et al. Preoperative evaluation of penetrating esophageal trauma in the current era: An analysis of the National Trauma Data Bank. J Emerg Trauma Shock, 2015, 8(1): 30-33.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

A comparison of clinical effects of removing foreign bodies from esophagus by rigid esophagoscope and flexible esophagoscope

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