title: AN EXPERIENCE OF BRONCHOTOMY AND RESECTIONAL PROCEDURES AFTER FAILED BRONCHOSCOPIC FOERIGN BODY RETRIEVAL.
abstract: BACKGROUND
  Foreign body bronchus is a surgical emergency and is associated with a high mortality if neglected or complicated. The objective of this study was to analyse the outcome of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval.
  
  
  METHODS
  This study of 24 cases of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval was done from June 2008 to June 2009 and March 2010 to Sep 2013. Patients after failed retrieval of foreign body by bronchoscopy either by ENT specialists or thoracic surgeons underwent bronchotomy or resectional procedures were included in the study. We used the posterolateral thoracotomy approach for the surgical procedures.
  
  
  RESULTS
  Bronchotomy and resectional procedures were done in 24 cases. Age of patients ranged from 2 years to 51 years. Most patients were children and right side was mostly involved. Bronchotomy procedures were 10 (41%) and resectional surgeries were 13 (58%). Emergency lobectonies were 3 out of 13 resectional surgeries. Right intermedius bronchus was opened up and incision was extended in the direction of foreign body in 6 cases and left bronchus intermedius was opened in 4 cases. Haemoptysis was the main symptom in late presenters. Range of objects retrieved in our study was from pins, needles to whistles.
  
  
  CONCLUSIONS
  Retention causes endobronchial obstruction with stasis leading to irreversible damaged parenchyma. Foreign body with structural changes require resection, others can be offered bronchotomy which is a safe procedure for retained non retrievable foreign bodies.
authors.forename: Yasser Saeed
authors.initials: YS
authors.lastname: Khan
authors.forename: Farhan Ahmed
authors.initials: FA
authors.lastname: Majeed
authors.forename: Syed Zahid Ali
authors.initials: SZ
authors.lastname: Shah
authors.forename: Munir Ahmad
authors.initials: MA
authors.lastname: Abbasi
authors.forename: Ahmed
authors.initials: A
authors.lastname: Raza
authors.forename: Tashfeen
authors.initials: T
authors.lastname: Imtiaz
authors.forename: Mohammad
authors.initials: M
authors.lastname: Imran
mesh_terms: D000293:Adolescent; D000328:Adult; D001980:Bronchi / Q000293:injuries / Q000601:surgery*; D001999:Bronchoscopy / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005547:Foreign Bodies / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation; D013997:Time Factors; D017211:Treatment Failure; D055815:Young Adult