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Endoscopic foreign body removal in the upper gastrointestinal tract: risk factors predicting conversion to surgery

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Abstract

Background/Aims

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.

Patients and 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.

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Disclosures

Ho-Jun Lee, Hyun-Soo Kim, Jin Jeon, Sang-Hun Park, Sung-Uk Lim, Chung-Hwan Jun, Seon-Young Park, Chang-Hwan Park, Sung-Kyu Choi, Jong-Sun Rew have no conflict of interest or financial ties to disclose.

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Authors and Affiliations

  1. Department of Internal Medicine, Chonnam National University Medical School, 8, Hak-dong, Dong-ku, Gwangju, 501-757, Korea

    Ho-Jun Lee, Hyun-Soo Kim, Jin Jeon, Sang-Hun Park, Sung-Uk Lim, Chung-Hwan Jun, Seon-Young Park, Chang-Hwan Park, Sung-Kyu Choi & Jong-Sun Rew

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  1. Ho-Jun Lee
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  2. Hyun-Soo Kim
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  3. Jin Jeon
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  4. Sang-Hun Park
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  5. Sung-Uk Lim
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  7. Seon-Young Park
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Correspondence to Hyun-Soo Kim.

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Lee, HJ., Kim, HS., Jeon, J. et al. Endoscopic foreign body removal in the upper gastrointestinal tract: risk factors predicting conversion to surgery. Surg Endosc 30, 106–113 (2016). https://doi.org/10.1007/s00464-015-4167-0

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  • DOI: https://doi.org/10.1007/s00464-015-4167-0

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