From rigid to flexible bronchoscopy: A tertiary center
experience in extraction of inhaled foreign bodies in children
Background: Rigid bronchoscopy is the procedure of choice for
removal of inhaled foreign bodies, with certain complication rate.
Aim : to assess whether flexible bronchoscopy is an efficient
and safe procedure in extraction of foreign bodies in children, compared
to rigid bronchoscopy. Then, to further assess if it is associated with
a shorter procedure time, and shorter length of stay in the hospital
(LOS).
Methods: a retrospective study including patients aged 0-18
years, that were hospitalized in Soroka University Medical Center
throughout 2009-2019, and underwent flexible or rigid bronchoscopy for
the removal of inhaled foreign body. The data were analyzed according to
two time periods; 2009-2016 and 2017-2019.
Results: from 2009-2019, 182 patients (median age of 24 months,
58% males) underwent an interventional bronchoscopy; 40 (22%) by
flexible and 142 (78%) by rigid bronchoscopy. 88.73% of rigid and 95%
of flexible bronchoscopies were successful in the removal of foreign
bodies (p value=0.24). The rate of major complications was higher among
rigid bronchoscopy (9.2 % vs. 0%, p =0.047). From 2017 onwards, after
implementation of the flexible bronchoscopy for removal of foreign
bodies, 64 procedures were performed; 33 (51.6%) flexible and 31
(48.4%) rigid. Procedure length was found to be shorter via flexible
bronchoscopy (42 vs 58 minutes, p = 0.016). No significant difference
was found in LOS.
Conclusion: Flexible bronchoscopy is an efficient and safe
method for removal of inhaled foreign bodies in children, with shorter
procedure time. It may be the primary procedure for removal of inhaled
foreign bodies.