Endoscopic removal of foreign bodies: A retrospective study in Japan
Endoscopic removal of foreign bodies: A retrospective study in Japan
复制标题
DOI：
10.4253/wjge.v12.i1.33
复制
发表时间：
2020-01-16
影响因子：
2
通讯作者：
Kanai, Takanori
中科院分区：
文献类型：
--
作者：
Kamiya, Kenji J. L. Limpias;Hosoe, Naoki;Kanai, Takanori
消化道异物和食物团嵌塞是临床常见的问题。处理这些问题的方法不断发展，提供了优点，例如避免手术、降低成本、改善可视化、降低发病率和高移除成功率。然而，到目前为止，没有研究已经评估了内镜下管理的FB在Japanes.AIMTo阐明水平的安全性和有效性内镜下管理的FB和FBI.METHODSA共215个程序进行了庆应义塾大学医院2007年11月和2018年8月之间。从病历中收集数据，从内窥镜报告系统中收集内窥镜详细信息。仅考虑使用柔性胃肠内窥镜进行的手术。仅纳入接受涉及消化道FB或FBI技术的患者。回顾性分析了患者性别、年龄、门诊患者、住院患者、FB类型、FB位置、手术时间、手术类型、取出器械类型、成功率和技术并发症等数据。在215例手术中，136例（63.3%）在老年人（≥ 60岁）中进行，180例（83.7%）在门诊患者中进行。最常见的FB类型为PTP药物[72例（33.5%）病例]、FBI [47例（21.9%）病例]、异尖线虫（AP）[41例（19.1%）病例]。FB主要位于食管[130例（60.5%）病例]，其次是胃[68例（31.6%）病例]。AP常见于胃[39例（57.4%）病例]，97.5%的病例使用活检钳切除。根据解剖位置，最常见的FB是咽喉中的PTP药物（40%）和牙科假体（DP）（40%），食管中的PTP（48.5%），胃中的AP（57.4%），小肠中的DP（37.5%）和结肠中的视频胶囊式内窥镜设备（75%）。带抓钳的透明帽是最常用的器械[82例（38.1%）病例]。手术成功率100%，并发症仅1例（0.5%）。
BACKGROUNDThe ingestion of foreign bodies (FBs) and food bolus impaction (FBI) in the digestive tract are commonly encountered clinical problems. Methods to handle such problems continue to evolve offering advantages, such as the avoidance of surgery, reduced cost, improved visualization, reduced morbidity, and high removal success rate. However, to date, no studies have evaluated the endoscopic management of FBs in Japan.AIMTo elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.METHODSA total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018. Data were collected from medical charts, and endoscopic details were collected from an endoscopic reporting system. Procedures performed with a flexible gastrointestinal endoscope were only taken into account. Patients who underwent a technique involving FB or FBI from the digestive tract were only included. Data on patient sex, patient age, outpatient, inpatient, FB type, FB location, procedure time, procedure type, removal device type, success, and technical complications were reviewed and analyzed retrospectively.RESULTSAmong the 215 procedures, 136 (63.3%) were performed in old adults (>= 60 years), 180 (83.7%) procedures were performed in outpatients. The most common type of FBs were press-through-pack (PTP) medications [72 (33.5%) cases], FBI [47 (21.9%)], Anisakis parasite (AP) [41 (19.1%) cases]. Most FBs were located in the esophagus [130 (60.5%) cases] followed by the stomach [68 (31.6%) cases]. AP was commonly found in the stomach [39 (57.4%) cases], and it was removed using biopsy forceps in 97.5% of the cases. The most common FBs according to anatomical location were PTP medications (40%) and dental prostheses (DP) (40%) in the laryngopharynx, PTP (48.5%) in the esophagus, AP (57.4%) in the stomach, DP (37.5%) in the small intestine and video capsule endoscopy device (75%) in the colon. A transparent cap with grasping forceps was the most commonly used device [82 (38.1%) cases]. The success rate of the procedure was 100%, and complication were observed in only one case (0.5%).CONCLUSIONEndoscopic management of FBs and FBI in our Hospital is extremely safe and effective.