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Updated: Jul 6, 2026

Systematic Bronchoscopy: the Four Landmarks Approach
Published on: June 23, 2023
[Airway foreign bodies removal with flexible bronchoscopy in children]
A Laín1, M Fanjul, M A García-Casillas
1Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid. alfhiler@yahoo.es
Insights
Flexible bronchoscopy is a safe and effective method for removing airway foreign bodies in children. This approach should be considered a primary treatment option for all pediatric patients requiring foreign body extraction.
Area of Science:
- Pediatric Pulmonology
- Pediatric Surgery
- Medical Devices
Background:
- Foreign body aspiration in children is a common and serious medical emergency.
- Traditional treatment involves rigid bronchoscopy.
- Flexible bronchoscopy is increasingly recognized as a viable alternative.
Purpose of the Study:
- To evaluate the effectiveness and safety of flexible bronchoscopy for airway foreign body removal in pediatric patients.
- To compare outcomes between flexible and rigid bronchoscopy in children.
Main Methods:
- Retrospective analysis of 65 children with foreign body aspiration.
- Comparison of two groups: rigid bronchoscopy (n=41) and flexible bronchoscopy (n=24).
- Key outcome measures included success rate, hospital stay, and complications.
Main Results:
- Both methods showed comparable results in terms of success rate, hospital stay, and complication rates.
- Flexible bronchoscopy group had a slightly lower average hospital stay.
- No statistically significant differences were found between the two groups for major outcomes.
Conclusions:
- Flexible bronchoscopy is a safe and efficient technique for pediatric airway foreign body removal.
- Flexible bronchoscopy should be considered a first-line treatment option for children.
- This method offers a valuable alternative to rigid bronchoscopy across all age groups.
Introduction:
Aspiration of foreign bodies in children is a frequent and potentially serious condition. Traditionally it has been solved by rigid bronchoscopy. Nowadays an increasing number of authors support the use of flexible bronchoscopy for its resolution.
Aim:
Analyze our experience in airway foreign body removal in children using flexible bronchoscopy.
Material And Methods:
We retrospectively analyzed 65 patients diagnosed of foreign body aspiration with a mean age of 3.65 + 3.1; 60% males and 40% females. We compared two historical cohorts of homogeneous distribution. The first one (group A), from 1994 to 1998, included 41 children treated by rigid bronchoscopy, and the second one (Group B) (1999-2006) 24 patients treated with the flexible bronchoscope. We studied: rate of success of initial extraction (RSIE), foreign body localization, type of foreign body, hospital stay, complications and mortality. Statistical analysis was done using t-student for cuantitative variables, and chi square for cualitative. Only a p < 0.05 was considered statistically significant. Data are presented as mean +/- standard error of the mean.
Results:
Group A had a medium hospital stay of 1.89 + 2.6 days. RSIE was 85.36%. Six patients needed a second therapeutic procedure (5 rigid bronchoscopies, 1 flexible brochoscopy). Complication rate was 4.87%: 2 cases of bronchitis. Group B presented a medium hospital stay of 1.34 +/- 0.27 days with a RSIE of 70.83%, needing a second intervention 7 children (4 fiberbonchoscopies, 3 rigid bronchoscopies). Postextraction complications in this group consisted of 1 bronchitis episode and a pneumothorax in 2 patients (8.33%). No deaths occurred in any group. No statistically significant differences were found in hospital stay, RSIE, type of second therapeutic procedure and complication rate.
Conclusions:
Our experience shows that flexible bronchoscopy removal of airway foreign bodies is safe and efficient; therefore, we think that it should be taken into account as first choice method of treatment at any age.
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