A systematic review of using flexible bronchoscopy to remove foreign bodies from paediatric patients

Area of Science:

• Pediatric Pulmonology
• Interventional Pulmonology
• Pediatric Airway Disorders

Background:

• Foreign body aspiration is a common pediatric emergency.
• Prompt diagnosis and intervention are crucial for favorable outcomes.
• Flexible bronchoscopy offers a minimally invasive approach for diagnosis and removal.

Purpose of the Study:

• To review the existing evidence on the efficacy and safety of flexible bronchoscopy for pediatric airway foreign body aspiration.
• To determine the success rates and complication profiles associated with this procedure.
• To identify common characteristics of foreign bodies and their locations.

Main Methods:

• A systematic search of the PubMed database was conducted for relevant peer-reviewed English-language studies published between January 2001 and October 2021.
• Studies focusing on flexible bronchoscopy as a first-line treatment for pediatric foreign body aspiration were included.
• Data extraction included success rates, complication rates, foreign body characteristics, and procedural details.

Main Results:

• Twenty-three studies comprising 2588 cases were analyzed.
• Flexible bronchoscopy achieved successful foreign body removal in 87.1% of cases.
• Complication rates were low (studied in 983 patients). Organic materials (78.3%) were common foreign bodies, often lodged in the right bronchial tree (50.5%). General anesthesia and laryngeal mask airways were frequently employed. Ancillary equipment, such as baskets, aided removal in 57.3% of cases.

Conclusions:

• Flexible bronchoscopy is a feasible and safe therapeutic option for select pediatric airway foreign body aspiration cases.
• The procedure demonstrates a high success rate and a low risk of complications.
• Future research should investigate comparative clinical outcomes between flexible and rigid bronchoscopy techniques.