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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2020; 12(1): 33-41
Published online Jan 16, 2020. doi: 10.4253/wjge.v12.i1.33
Endoscopic removal of foreign bodies: A retrospective study in Japan
Kenji JL Limpias Kamiya, Naoki Hosoe, Kaoru Takabayashi, Yukie Hayashi, Xi Sun, Ryoichi Miyanaga, Kayoko Fukuhara, Seiichiro Fukuhara, Makoto Naganuma, Atsushi Nakayama, Motohiko Kato, Tadateru Maehata, Rieko Nakamura, Koichi Ueno, Junichi Sasaki, Yuko Kitagawa, Naohisa Yahagi, Haruhiko Ogata, Takanori Kanai
Kenji JL Limpias Kamiya, Yukie Hayashi, Ryoichi Miyanaga, Makoto Naganuma, Takanori Kanai, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
Naoki Hosoe, Kaoru Takabayashi, Xi Sun, Kayoko Fukuhara, Seiichiro Fukuhara, Haruhiko Ogata, Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
Xi Sun, Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
Atsushi Nakayama, Motohiko Kato, Tadateru Maehata, Naohisa Yahagi, Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
Rieko Nakamura, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
Koichi Ueno, Junichi Sasaki, Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
Author contributions: All authors helped to perform the research; Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, Ueno K, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contributed to drafting conception; Limpias Kamiya KJL, Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, Ueno K, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contribution to design; Limpias Kamiya KJL, Hosoe N, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contribution to writing the manuscript; Limpias Kamiya KJL and Hosoe N performed procedures and analyzed the data; Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, and Ueno K contributed to performing the endoscopy.
Institutional review board statement: The present observational study was reviewed and approved by the ethics committee of Keio University Hospital (approval ID 20180281).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors disclosed no financial conflict of interest relevant to this publication.
STROBE statement: The authors have read the Strobe statement-checklist of items, and the manuscript was prepared according to the Strobe statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Naoki Hosoe, FACG, MD, PhD, Associate Professor, Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan.
nhosoe@z5.keio.jp
Received: June 24, 2019
Peer-review started: June 26, 2019
First decision: August 2, 2019
Revised: August 9, 2019
Accepted: November 18, 2019
Article in press: November 18, 2019
Published online: January 16, 2020
Processing time: 178 Days and 1.4 Hours
ARTICLE HIGHLIGHTS
Research background
Endoscopic extraction of foreign bodies (FBs) is a method that can present complications depending on the type of management performed.
Research motivation
To date, there are no studies evaluating the endoscopic management of FBs in Japan.
Research objectives
The aim of this study is to elucidate level of safety and efficacy in the endoscopic management of FBs and food boluses in Japan.
Research methods
This study was a retrospective medical record analysis. A 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 food bolus removal 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.
Research results
The most common type of FB were press-through-pack (PTP) [72 (33.5%) cases], food bolus [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]. The most common FBs according to anatomical location were PTP (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 was observed in only one case (0.5%).
Research conclusions
Endoscopic management of FBs is extremely safe and effective. The devices used for FB extraction depend on the location and type of FB.
Research perspectives
We suggest always placing a large caliber soft oblique cap on the tip of the endoscope and not a straight transparent cap, this will help avoid mucosal injury from the sharp edges during extraction and will provide a clear visual field.
