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Rigid versus flexible endoscopy for managing ingested foreign bodies-can we improve pathways?

Richard Jackson1, Emilien Chabrillac2,3, Alexandra Bell4

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European Archives of Oto-Rhino-Laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery
|February 5, 2022
PubMed
Summary

Flexible endoscopy (FE) and rigid endoscopy (RE) effectively treat upper gastrointestinal tract (UGIT) foreign bodies. FE, performed under local anesthesia, showed similar success rates to RE but with significantly fewer complications, making it a preferred first-line option.

Keywords:
Flexible endoscopyFood bolusForeign bodyOesophagusRigid endoscopy

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Area of Science:

  • Gastroenterology
  • Endoscopic Procedures
  • Medical Device Technology

Background:

  • Impacted foreign bodies in the upper gastrointestinal tract (UGIT) require prompt and safe management.
  • Endoscopic interventions are the primary treatment modality for UGIT foreign bodies.

Purpose of the Study:

  • To compare the management pathways, outcomes, and safety of rigid endoscopy (RE) and flexible endoscopy (FE) for impacted UGIT foreign bodies in adults.

Main Methods:

  • A retrospective study analyzed 144 adult patients undergoing either RE or FE for impacted UGIT foreign bodies over an 11-year period.
  • Data collected included procedure type, anesthesia, success rates, intra-procedural interventions, and complication rates.

Main Results:

  • Both FE (95 patients) and RE (49 patients) demonstrated high success rates (95.8% and 95.9%, respectively).
  • Flexible endoscopy was performed under local anesthesia or sedation, while rigid endoscopy required general anesthesia.
  • Complications were significantly lower with FE (6.3%) compared to RE (40.8%).
  • Intra-procedural biopsies during FE identified mucosal pathology in 27.4% of cases.

Conclusions:

  • Both flexible and rigid endoscopy are effective treatments for impacted UGIT foreign bodies.
  • Flexible endoscopy, with its lower complication rate and feasibility under local anesthesia, is favored as a first-line therapeutic option when possible.