title: Removal of tracheobronchial foreign bodies in adults using a flexible bronchoscope: experience with 200 cases in China.
abstract: OBJECTIVE
  Tracheobronchial foreign bodies (FBs) are frequently present in adults. This study reports our experience with the managements of FB and FB-related complications using flexible bronchoscopy.
  
  
  METHODS
  We retrospectively reviewed the adult patients with FBs treated between 2001 and 2011 in China. The demographic and endoscopic data were collected and analyzed.
  
  
  RESULTS
  A total of 200 adult patients (136 men and 64 women) with an average age of 51 years were analyzed. The most common FBs included bones (51.0%), nut shells (15.0%), food boluses (7.0%), plastic toys or pen caps (6.5%). After FB aspiration occurred, only 11.0% were diagnosed within three days, while more than half of the patients (58.0%) delayed the diagnosis by more than one month. The incidence of FB-related complications was 79.5%, including granulation formation (76.5%), obstructive pneumonia (22.0%), hemorrhage (14.5%), atelectasis (10.0%) and endobronchial stenotic scarring (8.0%). In 96.5% of the patients, the FBs were successfully removed under flexible bronchoscopy. A total of 53 out of the 153 patients with granulation (34.6%) were managed by argon plasma coagulation (APC) or cryotherapy; two out of the sixteen patients with endobronchial stenotic scars were treated by balloon dilation under flexible bronchoscopy.
  
  
  CONCLUSIONS
  A high incidence of FB-related complications occurs, likely as a result of the long delay between aspiration and diagnosis, a proportion of which require endoscopic intervention. The removal of FBs under flexible bronchoscopy has a high success rate and therefore should be recommended for adults.
authors.affiliation: Department of Respirology, Changhai Hospital, Second Military Medical University, P.R. China.
authors.forename: Yu-Chao
authors.initials: YC
authors.lastname: Dong
authors.forename: Guo-Wu
authors.initials: GW
authors.lastname: Zhou
authors.forename: Chong
authors.initials: C
authors.lastname: Bai
authors.forename: Hai-Dong
authors.initials: HD
authors.lastname: Huang
authors.forename: Qin-Ying
authors.initials: QY
authors.lastname: Sun
authors.forename: Yi
authors.initials: Y
authors.lastname: Huang
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Han
authors.forename: Qiang
authors.initials: Q
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D057908:Argon Plasma Coagulation; D044466:Asian People; D001980:Bronchi / Q000601:surgery*; D020680:Bronchoscopes / Q000145:classification*; D001999:Bronchoscopy / Q000295:instrumentation* / Q000379:methods*; D002681:China; D002921:Cicatrix / Q000628:therapy; D017679:Cryotherapy; D057210:Delayed Diagnosis / Q000009:adverse effects; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006097:Granulation Tissue; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014132:Trachea / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult