Retrospective Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Jun 9, 2024; 13(2): 91275
Published online Jun 9, 2024. doi: 10.5409/wjcp.v13.i2.91275
Flexible bronchoscopy for foreign body aspiration in children: A single-centre experience
Aleh Sautin, Kirjl Marakhouski, Aleh Pataleta, Kirill Sanfirau
Aleh Sautin, Kirjl Marakhouski, Aleh Pataleta, Kirill Sanfirau, Diagnostic Division, Republican Scientific and Practical Centre of Paediatric Surgery, Minsk 220013, Belarus
Author contributions: Sautin A writing original draft, conceptualization and design of the research; literature review and data collecting, text structuring and revising of the paper; Marakhouski K design of the research, performing therapeutic endoscopies, editing of the original draft, critical revision for important intellectual content and statistical analysis; Pataleta A and Sanfirau K analysis of clinical data, performing therapeutic endoscopies. All authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board of the Republican Scientific and Practical Centre of Paediatric Surgery (IRB No. 8.0).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have nothing to disclose.
Data sharing statement: Data is available upon reasonable request.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aleh Sautin, MBBS, Doctor, Diagnostic Division, Republican Scientific and Practical Centre of Paediatric Surgery, Nezavisimosti pr. 64A, Minsk 220013, Belarus. sautin.oleg@gmail.com
Received: December 26, 2023
Revised: April 21, 2024
Accepted: May 14, 2024
Published online: June 9, 2024
Processing time: 164 Days and 6.2 Hours
Abstract
BACKGROUND

The technological evolution of bronchoscopy has led to the widespread adoption of flexible techniques and their use for both diagnostic and therapeutic purposes. Currently, there is an active debate regarding the comparative efficacy and safety of rigid vs flexible bronchoscopy in the treatment of foreign body aspiration.

AIM

To evaluate our experience with tracheobronchial foreign body extraction using flexible bronchoscopy and provide a literature overview.

METHODS

This was a single-centre retrospective study. Twenty-four patients were enrolled between January 2017 and January 2023. Medical records of patients aged below 18 years who were admitted to authors’ affiliated institution with a suspected diagnosis of foreign body aspiration were collected from hospital’s database to Microsoft Excel 2019. Data were analysed using MedCalc Statistical Software.

RESULTS

Patient ages varied from 9 months to 11 years. The median age was 23.5 months, 95% confidence interval (CI) 19.49-44.77. We observed age clustering in children with foreign body aspiration at our institution with three age subgroups: (1) 0-25 months; (2) 40-60 months; and (3) 120-140 months. We expectancy of an organic tracheobronchial foreign body was significantly higher in 0-25 months subgroup than that in older ones when subgroups 40-60 and 120-140 months were combined together (odds ratio = 10.0, 95%CI: 1.44-29.26, P = 0.0197). Successful foreign body extraction was performed in all cases. Conversion to a rigid bronchoscope was not required in any of the cases. No major complications (massive bleeding, tracheobronchial tree perforation, or asphyxia) were observed.

CONCLUSION

Flexible bronchoscopy is an effective and safe method for tracheobronchial foreign body extraction in children.

Keywords: Foreign body aspiration, Tracheobronchial foreign body, Paediatric bronchoscopy, Flexible bronchoscopy, Rigid bronchoscopy

Core Tip: Foreign body aspiration is a well-known paediatric emergency issue, with a peak incidence at the age of 1-2 years. According to guidelines, rigid bronchoscopy remains the most widespread and acceptable treatment option for foreign body aspiration, while the role of flexible bronchoscopy is mainly limited to diagnostic purposes. A growing body of research has confirmed the safety and efficacy of flexible bronchoscopy as a therapeutic option. Literature data and our data indicate that flexible bronchoscopy may be considered a competitive alternative to rigid techniques, especially in relation to the distal tracheobronchial tree in young children.