The Outcome Of Telescopic Rigid Bronchoscopy For Management Of Aspirated Tracheobronchial Foreign Body In Children
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Objectives: This study aimed to evaluate the outcome of the use of rigid bronchoscopy in association with telescope for aspirated tracheobronchial foreign body (TBFB) extraction in children. Patients and Methods: The study included 30 children; 19 males (63.3%) and 11 females (36.7%) with mean age of 4.42.1 years. After detailed history taking and clinical examination, Chest X-rays in full inspiratory and expiratory phases, were obtained and then, all patients underwent rigid bronchoscopy. Results: Mean time elapsed since aspiration till presentation was 27.330.6; range: 2-96 hours. Penetration syndrome was the frequent mode of presentation reported in 21 children (70%). Radiological examination cOuld identify 6 radioopaque FB and identified the site of obstructing FB in another 13 patients, but was negative in 11 patients. All patients were proved to have TBFB which was extraced bronchoscopically, thus preoperative radiology showed a sensitivity of 63.3%. Bronchoscope was inserted once in 20 patients (66.7%), twice in 7 patients (23.3%) and only 4 patients had 3 insertions. Grasping attempts during FB removal were once in 11 patients (36.7%), twice in 17 patients (56.7%) and trice in 2 patients (6.6%) with a mean number of bronchoscopic insertions and grasping attempts was 1.40.7 and 1.70.6 times, respectively. No mucosal abrasions occurred in 16 patients (53.3%), while mucosal abrasions occurred in 14 patients (46.7%) but controllable bleeding was reported in 6 patients (20%); 4 had 2 mucosal abrasions, one had 3 abrasions and the 6th had only one abrasion. No major complications were encountered, however, further FB impaction occurred in 3 patients (10%) owing to the accidental pushing down of the object during the procedure, however, bronchoscope re-insertion for trial to disimpact and grasp FB succeeded in 2 patients and in the 3rd the use of ureteric catheter with basket undervision allowed FB disimpaction and its extraction. The mean operative time was 24.28.3 minutes. The mean hospital stay was 37.215.9; range: 24-72 hours. Organic FB was extracted from 23 children (76.7%), while non-organic FB was extracted from 7 children (22.3%).