Flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults.
OBJECTIVE
To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults.


METHODS
This was a retrospective study of all adult patients (over 18 years of age) with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of São Paulo School of Medicine Hospital das Clínicas, located in São Paulo, Brazil.


RESULTS
The study sample comprised 40 adult patients, with a mean age of 52 years (range, 18-88 years). The median time of permanence of the foreign body in the airway was 15 days (range, 12 h to 10 years). All of the patients first underwent diagnostic flexible bronchoscopy. Foreign bodies were successfully removed with flexible bronchoscopy in 33 (82.5%) of the patients. In 1 patient, a metal object lodged in the distal bronchial tree required the use of fluoroscopy. Six patients (15%) required rigid bronchoscopy due to tracheal foreign body-induced dyspnea, in 2, and because the foreign body was too large for the flexible forceps, in 4. Bronchoscopy failed in 1 patient, who therefore required surgical bronchotomy.


CONCLUSIONS
Although rigid bronchoscopy is considered the gold standard for the removal of foreign bodies from the airways, our experience showed that flexible bronchoscopy can be safely and effectively used in the diagnosis and treatment of stable adult patients.
Instituto do Coração, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. ascedio@gmail.com
Ascedio José
AJ
Rodrigues
Eduardo Quintino
EQ
Oliveira
Paulo Rogério
PR
Scordamaglio
Marcelo Gervilla
MG
Gregório
Márcia
M
Jacomelli
Viviane Rossi
VR
Figueiredo
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000402:Airway Obstruction / Q000601:surgery; D001980:Bronchi; D001999:Bronchoscopy / Q000009:adverse effects / Q000379:methods*; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007830:Larynx; D008875:Middle Aged; D053120:Respiratory Aspiration / Q000601:surgery; D012189:Retrospective Studies; D014132:Trachea; D016896:Treatment Outcome; D055815:Young Adult