[Airway foreign bodies removal with flexible bronchoscopy in children].
BACKGROUND
Aspiration of foreign bodies in children is a frequent and potentially serious condition. Traditionally it has been solved by rigid bronchoscopy. Nowadays an increasing number of authors support the use of flexible bronchoscopy for its resolution.


OBJECTIVE
Analyze our experience in airway foreign body removal in children using flexible bronchoscopy.


METHODS
We retrospectively analyzed 65 patients diagnosed of foreign body aspiration with a mean age of 3.65 + 3.1; 60% males and 40% females. We compared two historical cohorts of homogeneous distribution. The first one (group A), from 1994 to 1998, included 41 children treated by rigid bronchoscopy, and the second one (Group B) (1999-2006) 24 patients treated with the flexible bronchoscope. We studied: rate of success of initial extraction (RSIE), foreign body localization, type of foreign body, hospital stay, complications and mortality. Statistical analysis was done using t-student for cuantitative variables, and chi square for cualitative. Only a p < 0.05 was considered statistically significant. Data are presented as mean +/- standard error of the mean.


RESULTS
Group A had a medium hospital stay of 1.89 + 2.6 days. RSIE was 85.36%. Six patients needed a second therapeutic procedure (5 rigid bronchoscopies, 1 flexible brochoscopy). Complication rate was 4.87%: 2 cases of bronchitis. Group B presented a medium hospital stay of 1.34 +/- 0.27 days with a RSIE of 70.83%, needing a second intervention 7 children (4 fiberbonchoscopies, 3 rigid bronchoscopies). Postextraction complications in this group consisted of 1 bronchitis episode and a pneumothorax in 2 patients (8.33%). No deaths occurred in any group. No statistically significant differences were found in hospital stay, RSIE, type of second therapeutic procedure and complication rate.


CONCLUSIONS
Our experience shows that flexible bronchoscopy removal of airway foreign bodies is safe and efficient; therefore, we think that it should be taken into account as first choice method of treatment at any age.
Laín
A
A
Servicio Cirugía Pediátrica, Hospital General Universitario Gregorio Marañón, Madrid. alfhiler@yahoo.es
Fanjul
M
M
García-Casillas
M A
MA
Parente
A
A
Cañizo
A
A
Carreras
N
N
Matute
J A
JA
Vázquez
J
J
D001980:Bronchi; D001999:Bronchoscopy; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005547:Foreign Bodies / Q000628:therapy*; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D014132:Trachea