J Korean Med Sci.  2023 Jan;38(1):e2. 10.3346/jkms.2023.38.e2.

Clinical Experiences and Selection of Accessory Devices for Pediatric Endoscopic Foreign Body Removal: A Retrospective Multicenter Study in Korea

• Lee YJ
• Lee JH
• Park KY
• Park JS
• Park JH
• Lim TJ
• Myong JP
• Chung JH
• Seo JH

• KMID: 2537446
• DOI: http://doi.org/10.3346/jkms.2023.38.e2

Abstract

Background
Swallowing of foreign bodies (FBs) is the most common indication of therapeutic endoscopy in children. Endoscopic removal may be necessary depending on the type of FB, age of the child, and location of the FB. We attempted to analyze the characteristics of each device used for the endoscopic removal of FBs in children.
Methods
Medical records of the patient’s age, sex, weight, type, location, size, shape, type of device used for endoscopic removal, and endoscopic time were retrospectively collected.
Results
A total of 424 FB removal procedures were analyzed. The average age of the patients at the time of FB removal was 4.1 ± 3.7 years. Coins were the most common FBs (192, 45.3%). The most common locations of the FBs were the esophagus (45.7%) and the stomach (48.3%), respectively. For a total of 371 cases, forceps were used in 96 cases (25.9%) for esophageal FBs and in 25 cases for gastric FBs (6.7%), while nets were used in 250 cases (67.4%) for gastric FBs retrieval; the average durations of the procedures were 7.2 ± 7.4 minutes, 8.5 ± 7.2 minutes, and 5.7 ± 7.3 minutes, respectively (P = 0.003). The procedure time was significantly shorter, in the group of patients with low body weights, when nets were used than when forceps were used to remove gastric FBs (P = 0.001).
Conclusion
The endoscopic procedure duration, in low-weight children, was shorter when retrieval nets were used than that with forceps.

Keyword

Foreign Body; Child; Endoscopic Removal

Figure

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  Fig. 1 Procedure duration for endoscopic FB removal according to the locations of the FB and devices used when both tools were clinically available (n = 371). (A) Lower body weight group (less than 14.9 kg, n = 188) showed significant shorter procedure duration for gastric FBs retrieval using retrieval nets than for gastric and esophageal FBs retrieval using forceps (P = 0.005 and P = 0.008, respectively). (B) Larger body weight group (more than 14.9 kg, n = 183) also showed shorter procedure duration during retrieval using retrieval nets than during retrieval using forceps (P = 0.026).FB = foreign body.

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  Fig. 2 Summarized illustration for endoscopic foreign body removal with retrieval net (A) versus with forceps (B). Roth net are most often successful because there are little chances for the FBs to slip out.FB = foreign body.

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