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[Therapeutic problems of pediatric tracheobronchial foreign bodies]
U Hofmann1, K Mantel, I Butenandt
1Anästhesieabteilung, Universität Mäunchen.
Insights
Bronchoscopic extraction of tracheo-bronchial foreign bodies is a high-risk procedure in children, especially infants. Advances in pediatric anesthesia and specialized devices improve safety and efficacy for these complex cases.
Area of Science:
- Pediatric Surgery
- Pulmonology
- Medical Devices
Context:
- Tracheo-bronchial foreign bodies pose significant risks in pediatric patients.
- Bronchoscopy is the primary intervention but carries inherent risks, particularly in infants.
Purpose:
- To review the techniques and outcomes of tracheo-bronchial foreign body extraction.
- To highlight advancements facilitating safer pediatric bronchoscopy.
- To introduce a novel method for extracting crumbly foreign bodies.
Summary:
- Analysis of 251 tracheo-bronchial foreign body extractions since 1968.
- Emphasizes the need for skilled bronchologists due to procedural risks.
- Details extraction techniques, monitoring, and perioperative management.
- Presents a new forceps-free method for removing crumbly materials like peanuts.
Impact:
- Improved understanding of managing pediatric tracheo-bronchial foreign bodies.
- Highlights the role of technological and anesthetic advancements.
- Offers a novel solution for challenging foreign body types, potentially reducing complications.
Abstract:
The report is based on 251 extractions of tracheo-bronchial foreign bodies performed since 1968. Bronchoscopy for foreign bodies, particularly chronic ones, is a high risk procedure in small children and even more in infants and should be limited to a skilled bronchologist. Progress in paediatric anaesthesiology and paediatric intensive care as well as bronchological devices designed specially for children facilitate the task. Technique of extraction, monitoring and pre- and postoperative management are described in detail. A recently developed method for the extraction of crumbly material, particularly peanuts, without forceps is presented.