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Published on: June 6, 2020
Risk factors for difficult removal of tracheobronchial foreign bodies in children by rigid bronchoscopy
Ling Ding1, Xiujing Su1, Dazhi Yang1
1Department of Otolaryngology-Head and Neck Surgery, Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing, China.
Insights
Pediatric tracheobronchial foreign body (FB) removal is usually successful. However, factors like older age, larger FB diameter, left bronchus location, and granulation tissue increase difficulty.
Area of Science:
- Pediatric Pulmonology
- Bronchoscopy
- Foreign Body Aspiration
Background:
- Foreign body aspiration is a common pediatric emergency.
- Rigid bronchoscopy is the primary intervention for tracheobronchial foreign bodies (FBs).
- Identifying risk factors for difficult FB removal is crucial for optimizing patient outcomes.
Purpose of the Study:
- To identify risk factors associated with difficult removal of tracheobronchial foreign bodies (FBs) in children using rigid bronchoscopy.
Main Methods:
- Retrospective analysis of clinical data from 1026 pediatric patients (0-18 years) with tracheobronchial FBs.
- All patients underwent rigid bronchoscopy as the initial treatment.
- Risk factors for difficult FB removal were assessed through univariate and multivariate analyses.
Main Results:
- Rigid bronchoscopy achieved a 97.27% success rate in a single attempt.
- Difficult FB removal occurred in 12.18% of cases.
- Independent risk factors for difficult removal included age ≥3 years, FB diameter ≥10 mm, left bronchus location, multiple FBs, granulation tissue, and surgeon's experience ( <3 or ≥5 years).
Conclusions:
- Age, FB diameter, location, granulation tissue, and surgeon seniority are significant risk factors for difficult tracheobronchial FB removal.
- These findings can help predict and manage challenging cases.
Objective:
To characterize the risk factors for difficult removal of tracheobronchial foreign body (FB) by rigid bronchoscopy in children.
Methods:
We retrospectively analyzed clinical data of 1026 pediatric patients (age: 0-18 years) diagnosed with tracheobronchial FB between September 2018 and August 2021. All patients underwent rigid bronchoscopy as the first intervention at our hospital.
Results:
Children aged 1-3 years accounted for 83.7% cases in our cohort. The most common symptoms were cough and wheeze. FBs were more frequently found in the right bronchus, and trachea FBs accounted for only 8.19% cases. The success rate of rigid bronchoscopy in a single attempt was 97.27%. 12.18% of the cases were defined as difficult removal of FB. On univariate analysis, age, CT findings (pneumonia), type of FB, diameter of FB, FB location, granulation tissue formation, and the seniority of the surgeon were identified as risk factors for difficult removal of tracheobronchial FBs. On multivariate analysis, age ≥3 years, FB diameter ≥10 mm, FBs located in left bronchus, multiple FBs, granulation tissue, and the seniority of surgeon (<3 years, ≥5 years) were independent risk factors for difficult removal.
Conclusions:
Age, FB diameter, location of FB, granulation tissue formation, and the seniority of the surgeon were risk factors for difficult removal of FBs by rigid bronchoscopy.
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