Complication rates in rigid vs. flexible endoscopic foreign body removal in children

Area of Science:

• Pediatric Pulmonology
• Interventional Bronchoscopy
• Patient Safety

Background:

• Foreign body aspiration is a significant cause of pediatric morbidity and mortality.
• Current recommendations for removal techniques may not align with clinical practice.
• Limited data exists on the success and complication rates of pediatric foreign body removal.

Purpose of the Study:

• To establish a classification system for bronchoscopy-related complications in foreign body removal.
• To prospectively record and analyze complications associated with rigid versus flexible bronchoscopy.
• To compare the safety and efficacy of rigid and flexible bronchoscopy for pediatric foreign body removal.

Main Methods:

• Development of a standardized complication classification system.
• Anonymous case contributions from foreign body removal specialists.
• Prospective data collection on procedural details, complications, and patient characteristics.
• Statistical analysis using Pearson's Chi Square test for correlation.

Main Results:

• A total of 314 rigid and 178 flexible bronchoscopies were analyzed.
• Overall complication rates were comparable: 19.1% for rigid and 24.2% for flexible bronchoscopy (p=0.232).
• Respiratory complications were significantly lower with rigid bronchoscopy (9.2%) compared to flexible bronchoscopy (16.3%) (p=0.025).

Conclusions:

• This study represents the largest pediatric case series comparing complications between rigid and flexible foreign body removal.
• Flexible bronchoscopy demonstrated a higher incidence of respiratory complications, validating clinical concerns.
• Flexible bronchoscopy can be a safe option when accompanied by enhanced respiratory monitoring and immediate airway management capabilities.