Safety of surgical removal of aspirated foreign bodies after failure of bronchoscopy removal

Foreign body (FB) aspiration is uncommon, but potentially serious and life-threatening. Foreign body aspiration represents about 0.5% of adult bronchoscopy procedures. When bronchoscopic removal fails, the procedure should stop and a thoracic surgeon must join the procedure, and the most common surgical strategy is lobectomy. The aim of this study is to describe the outcome and safety of surgical removal of aspirated foreign bodies through minimal thoracic surgery after failure of bronchoscopic removal. This is a descriptive hospital study that involved 21 patients hospitalized in two main hospitals in Khartoum, Sudan, between September 2013 and October 2019, for the surgical removal of aspirated foreign bodies. We collected data on the demographics and clinical characteristics of the patients, the nature and anatomical location of the foreign body, and the surgical results. The descriptive hospital-based study involved 21 patients hospitalized in the thoracic surgery department in two main hospitals in Khartoum, Sudan, in the period between September 2013 and October 2019, for surgical removal of aspirated FBs following unsuccessful removal by a bronchoscope. We collected the data about patients’ demographics and clinical features, FB nature and anatomical location, and surgery outcomes. The mean age of the patients was 14 years and 12 of them were women. The incident was accidental in all patients, and the mean time between the foreign body aspiration and surgery was approximately 2 weeks. Foreign bodies were found in the right lung in 15 of the patients. All foreign body removals were achieved by minimally invasive thoracic surgery. In 17 patients, the surgery was conservative, but two patients underwent lobectomy and pneumonectomy was performed in 2 patients. The postoperative course was favorable in all patients and no deaths were reported. During the study period, 21 patients were referred for surgical removal of an aspirated FB. The mean age of participants was 14 years; 12 were females; inhalation was accidental in all cases; the average interval between the FB inhalation and surgery was 14 days. In 15 patients, the FBs were in the right tracheobronchial tree. All FB removals were by minimal thoracic surgery; 17 patients had conservative surgery, two patients had complete lung removal, and two patients had a lung lobe removed. The postoperative course was favorable in all patients, and there were no reported deaths. Minimally invasive thoracic surgery in our setting has provided a safe approach to the removal of aspirated foreign bodies after failure of bronchoscopic removal. Keywords: Bronchoscopy, foreign body, aspiration, lobectomy, pneumonectomy, scarf pin, and thoracotomy