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From rigid to flexible bronchoscopy: A tertiary center experience in extraction of inhaled foreign bodies in children
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  • Inbal Golan-Tripto,
  • Dina Weinstein,
  • Sergey Tsaregorodtsev,
  • Liran Stiler-Timor,
  • Yotam Dizitzer,
  • Aviv Goldbart,
  • Micha Aviram
Inbal Golan-Tripto
Soroka University Medical Center
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Dina Weinstein
Ben-Gurion University of the Negev Faculty of Health Sciences
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Sergey Tsaregorodtsev
Soroka Medical Center
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Liran Stiler-Timor
Soroka Medical Center
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Yotam Dizitzer
Soroka University Medical Center
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Aviv Goldbart
Ben Gurion University of the Negev and Soroka Medical Center
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Micha Aviram
Soroka Medical Center
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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.

Peer review status:UNDER REVIEW

03 Aug 2020Submitted to Pediatric Pulmonology
04 Aug 2020Assigned to Editor
04 Aug 2020Submission Checks Completed
06 Aug 2020Review(s) Completed, Editorial Evaluation Pending