title: Endoscopic foreign body removal in the upper gastrointestinal tract: risk factors predicting conversion to surgery.
abstract: OBJECTIVE
  Most foreign bodies of the upper gastrointestinal tract (UGIT) are successfully removed by endoscopic techniques without complications. However, some require conversion to surgery due to failure of endoscopic removal. The aim of this study was to analyze the risk factors predicting the need to convert to surgery after inability to endoscopically remove the foreign body.
  
  
  METHODS
  The medical records of 885 patients treated between January 2006 and March 2014 for suspected foreign bodies in the UGIT were retrospectively reviewed. Patient characteristics, the type of foreign bodies, clinical outcomes, and risk factors predicting the conversion to surgery were analyzed.
  
  
  RESULTS
  While endoscopic removal was successful in 94.7% (665/702) of the patients, the remaining 5.3% (37/702) needed conversion to surgery. There were no procedure-related deaths. According to the multivariate logistic regression analyses, older age (>70 years, p = 0.004), location (upper esophagus, p = 0.001), larger size (maximal diameter > 30 mm, p = 0.005), and longer impaction time (>40 h, p < 0.001) were significant risk factors predicting conversion to surgery due to inability to remove the foreign body endoscopically.
  
  
  CONCLUSIONS
  Most of the foreign bodies in the UGIT were successfully removed by endoscopic techniques. However, surgical removal might need to be considered in patients with age >70 years, and those with foreign bodies in the upper esophagus, maximal diameter >30 mm, and impaction time >40 h, due to the possible high failure rate of endoscopic removal.
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea. joon8970@hanmail.net.
authors: Ho-Jun
authors: HJ
authors: Lee
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea. dshskim@hanmail.net.
authors: Hyun-Soo
authors: HS
authors: Kim
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Jin
authors: J
authors: Jeon
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Sang-Hun
authors: SH
authors: Park
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Sung-Uk
authors: SU
authors: Lim
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Chung-Hwan
authors: CH
authors: Jun
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Seon-Young
authors: SY
authors: Park
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Chang-Hwan
authors: CH
authors: Park
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Sung-Kyu
authors: SK
authors: Choi
authors: Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea.
authors: Jong-Sun
authors: JS
authors: Rew
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D061887:Conversion to Open Surgery; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005547:Foreign Bodies / Q000601:surgery*; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D041742:Upper Gastrointestinal Tract / Q000601:surgery*; D055815:Young Adult
keywords: Digestive; G-I < endoscopy; Technical < endoscopy