From rigid to flexible bronchoscopy: A tertiary center experience in
extraction of inhaled foreign bodies in children
Abstract
Background: Rigid bronchoscopy is the procedure of choice for removal of
inhaled foreign bodies, with certain complication rate. Aim: to assess
whether flexible bronchoscopy is an efficient and safe procedure in
extraction of foreign bodies in children, compared to rigid
bronchoscopy. Then, to further assess if it is associated with a shorter
procedure time, and shorter length of stay in the hospital (LOS).
Methods: a retrospective study including patients aged 0-18 years, that
were hospitalized in Soroka University Medical Center throughout
2009-2019, and underwent flexible or rigid bronchoscopy for the removal
of inhaled foreign body. The data were analyzed according to two time
periods; 2009-2016 and 2017-2019. Results: from 2009-2019, 182 patients
(median age of 24 months, 58% males) underwent an interventional
bronchoscopy; 40 (22%) by flexible and 142 (78%) by rigid
bronchoscopy. 88.73% of rigid and 95% of flexible bronchoscopies were
successful in the removal of foreign bodies (p value=0.24). The rate of
major complications was higher among rigid bronchoscopy (9.2 % vs. 0%,
p =0.047). From 2017 onwards, after implementation of the flexible
bronchoscopy for removal of foreign bodies, 64 procedures were
performed; 33 (51.6%) flexible and 31 (48.4%) rigid. Procedure length
was found to be shorter via flexible bronchoscopy (42 vs 58 minutes, p =
0.016). No significant difference was found in LOS. Conclusion: Flexible
bronchoscopy is an efficient and safe method for removal of inhaled
foreign bodies in children, with shorter procedure time. It may be the
primary procedure for removal of inhaled foreign bodies.