Lucas Dourado Mapurunga Pereira, Márcio Alencar Barreira, Thiago Nepomuceno de Saboia Mont'Alverne, Marina Marques Maia, Marcela Alina Jereissati de Castro, Joao Wallace Carvalho de Oliveira, Mariana Marques Maia, Paulo Roberto Cavalcante de Vasconcelos, Alessandrino Terceiro de Oliveira
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It is important to study the epidemiological profile and endoscopic methods for treating FB impacted in the esophagus of children, as it can help in the development of more effective, safe and personalized preventive and therapeutic strategies.</p><p><strong>Aim: </strong>To define the profile of children seeking emergency care due to FB impaction in the esophagus, analyze factors associated with complications, and evaluate the effectiveness of rigid (RE) and flexible endoscopes (FE).</p><p><strong>Methods: </strong>A retrospective cohort study of 166 children with impacted FB in the esophagus who underwent an endoscopy (FE = 84 <i>vs</i> RE = 82) at the Dr. José Frota Institute was performed. The primary outcomes were to assess the efficacy of the endoscopic technique and factors associated with complications. The secondary outcomes were age group, gender, symptoms, length of hospital stay, and location of the FB.</p><p><strong>Results: </strong>Boys (66.9%), preschoolers (43.4%), FB > 24 hours (62.7%), cervical esophagus (60.8%), coin ingestion (57.2%) and complaints of dysphagia (24.9%) and sialorrhea (23.1%) were the predominant findings. Endoscopy was successful (90.4%) with sedation (89.1%). A total of 97% of patients were discharged from the hospital, while 3% died. The average hospital stay length was 2.6 days. Most patients did not experience complications predominated (64.5%). Esophageal perforations were more frequent after RE (11% <i>vs</i> 4.8%), while FE was more effective (95.2% <i>vs</i> 85.4%). The <i>χ</i> <sup>2</sup> test or Fisher's exact test was used to compare categorical variables. For continuous variables, the Kruskal-Wallis test or analysis of variance was used. Statistical analyses were performed in R<sup>®</sup> software (version 1.3.1093).</p><p><strong>Conclusion: </strong>Coins were the most frequent FBs and were mainly lodged in the upper esophagus of preschool boys. Risk factors for complications due to esophageal FB include battery ingestion, delayed removal (> 48 hours) and lodging in the thoracic esophagus. 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Most esophageal FB impaction emergencies occur in children. It is important to study the epidemiological profile and endoscopic methods for treating FB impacted in the esophagus of children, as it can help in the development of more effective, safe and personalized preventive and therapeutic strategies.</p><p><strong>Aim: </strong>To define the profile of children seeking emergency care due to FB impaction in the esophagus, analyze factors associated with complications, and evaluate the effectiveness of rigid (RE) and flexible endoscopes (FE).</p><p><strong>Methods: </strong>A retrospective cohort study of 166 children with impacted FB in the esophagus who underwent an endoscopy (FE = 84 <i>vs</i> RE = 82) at the Dr. José Frota Institute was performed. The primary outcomes were to assess the efficacy of the endoscopic technique and factors associated with complications. 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引用次数: 0
摘要
背景：异物（FB）摄入是内镜医师面临的最具挑战性的临床情况之一。大多数食管FB嵌塞急诊发生在儿童身上。研究儿童FB影响食道的流行病学概况和内镜治疗方法，有助于制定更有效、安全、个性化的预防和治疗策略。目的：明确因FB嵌塞食管而寻求急诊治疗的儿童的概况，分析并发症的相关因素，并评估刚性内窥镜（RE）和柔性内窥镜（FE）的有效性。方法：在Dr. jos Frota研究所进行了一项回顾性队列研究，对166名食道内嵌FB儿童进行了内窥镜检查（FE = 84 vs RE = 82）。主要结果是评估内窥镜技术的疗效和与并发症相关的因素。次要结局是年龄、性别、症状、住院时间和FB的位置。结果：男孩（66.9%）、学龄前儿童（43.4%）、FB bb0 24小时（62.7%）、颈部食道（60.8%）、硬币摄入（57.2%）、吞咽困难（24.9%）和唾液（23.1%）为主要表现。内镜检查成功（90.4%），镇静（89.1%）。97%的患者出院，3%的患者死亡。平均住院时间为2.6天。大多数患者未发生并发症（64.5%）。RE术后食管穿孔发生率更高（11% vs 4.8%），而FE术后食管穿孔发生率更高（95.2% vs 85.4%）。使用χ 2检验或Fisher精确检验来比较分类变量。对于连续变量，采用Kruskal-Wallis检验或方差分析。采用R®软件（1.3.1093版）进行统计分析。结论：硬币是最常见的FBs，主要卡在学龄前男孩的上食道。食道FB并发症的危险因素包括误食电池、延迟取出（约48小时）和在胸段食道内倒伏。FE通常比RE更有效地去除FBs；这两个过程都是安全的。
Endoscopic techniques and factors for complications in pediatric esophageal foreign body removal.
Background: Foreign body (FB) ingestion is one of the most challenging clinical situations faced by endoscopists. Most esophageal FB impaction emergencies occur in children. It is important to study the epidemiological profile and endoscopic methods for treating FB impacted in the esophagus of children, as it can help in the development of more effective, safe and personalized preventive and therapeutic strategies.
Aim: To define the profile of children seeking emergency care due to FB impaction in the esophagus, analyze factors associated with complications, and evaluate the effectiveness of rigid (RE) and flexible endoscopes (FE).
Methods: A retrospective cohort study of 166 children with impacted FB in the esophagus who underwent an endoscopy (FE = 84 vs RE = 82) at the Dr. José Frota Institute was performed. The primary outcomes were to assess the efficacy of the endoscopic technique and factors associated with complications. The secondary outcomes were age group, gender, symptoms, length of hospital stay, and location of the FB.
Results: Boys (66.9%), preschoolers (43.4%), FB > 24 hours (62.7%), cervical esophagus (60.8%), coin ingestion (57.2%) and complaints of dysphagia (24.9%) and sialorrhea (23.1%) were the predominant findings. Endoscopy was successful (90.4%) with sedation (89.1%). A total of 97% of patients were discharged from the hospital, while 3% died. The average hospital stay length was 2.6 days. Most patients did not experience complications predominated (64.5%). Esophageal perforations were more frequent after RE (11% vs 4.8%), while FE was more effective (95.2% vs 85.4%). The χ2 test or Fisher's exact test was used to compare categorical variables. For continuous variables, the Kruskal-Wallis test or analysis of variance was used. Statistical analyses were performed in R® software (version 1.3.1093).
Conclusion: Coins were the most frequent FBs and were mainly lodged in the upper esophagus of preschool boys. Risk factors for complications due to esophageal FB include battery ingestion, delayed removal (> 48 hours) and lodging in the thoracic esophagus. FE was generally more effective than RE for removing FBs; both procedures are safe.
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