Removal of foreign bodies from the respiratory tract of young children: Treatment outcomes using newly developed foreign-body grasping forceps

• Published in: Journal of pediatric surgery 2016-08, Vol.51 (8), p.1375-1379
• Main Authors: Endoh, Makoto, Oizumi, Hiroyuki, Kanauchi, Naoki, Kato, Hirohisa, Ota, Hiroshi, Suzuki, Jun, Watarai, Hikaru, Nakamura, Megumi, Sadahiro, Mitsuaki
• Format: Article
• Language: English
• Subjects: Airway; Bronchoscopy - instrumentation; Child; Child, Preschool; Female; Flexible bronchoscope; Forceps; Foreign Bodies - surgery; Foreign body; Humans; Infant; Laryngeal mask; Male; Operative Time; Pediatrics; Respiratory System; Retrospective Studies; Surgery; Surgical Instruments; Trachea; Treatment Outcome
• ISSN: 0022-3468; 1531-5037
• DOI: 10.1016/j.jpedsurg.2016.02.045

Abstract Background Although a foreign body in the airway of children constitutes a medical emergency, most available therapeutic tools are insufficient, and treatment can be difficult. Herein, we evaluated the outcomes of various treatment methods of foreign body removal from the respiratory tract. Methods We retrospectively analyzed 24 children (13 boys, 11 girls; median age, 18 months [range, 9–60 months]) treated for airway foreign bodies from January 1994 to December 2013 by examining their preoperative diagnoses and anesthesia and surgical methods. Results The foreign body was a peanut, green soybean, almond, chestnut, dental prosthesis, and bead in 15, 3, 3, 1, 1, and 1 cases, respectively. General anesthesia was used in all cases, and flexible bronchoscopy was performed under airway maintenance using a laryngeal mask in 23 cases. The mean operation time was 51 ± 32 min. Grasping forceps, basket forceps, and a Fogarty catheter were used in 14, 7, and 2 cases, respectively. In July 2003, 3-pronged foreign-body grasping forceps with a 2.0-mm diameter designed for use with a thin bronchoscope were introduced. Of 16 treated cases, 9 were successfully treated with only forceps. The mean operation time was significantly shortened to 38 ± 24 min (range, 7–91 min) compared to the traditional operation time of 82 ± 42 min (range, 23–147 min) ( p = 0.01 ). Conclusions These novel forceps are useful for reducing the operation time and are suitable for removing airway foreign bodies from children with a narrow tracheobronchial caliber.