[Airway foreign bodies removal with flexible bronchoscopy in children].

INTRODUCTION: Aspiration of foreign bodies in children is a frequent and potentially serious condition. Traditionally it has been solved by rigid bronchoscopy. Nowadays an increasing number of authors support the use of flexible bronchoscopy for its resolution.

AIM: Analyze our experience in airway foreign body removal in children using flexible bronchoscopy.

MATERIAL AND METHODS: We retrospectively analyzed 65 patients diagnosed of foreign body aspiration with a mean age of 3.65 + 3.1; 60% males and 40% females. We compared two historical cohorts of homogeneous distribution. The first one (group A), from 1994 to 1998, included 41 children treated by rigid bronchoscopy, and the second one (Group B) (1999-2006) 24 patients treated with the flexible bronchoscope. We studied: rate of success of initial extraction (RSIE), foreign body localization, type of foreign body, hospital stay, complications and mortality. Statistical analysis was done using t-student for cuantitative variables, and chi square for cualitative. Only a p < 0.05 was considered statistically significant. Data are presented as mean +/- standard error of the mean.

RESULTS: Group A had a medium hospital stay of 1.89 + 2.6 days. RSIE was 85.36%. Six patients needed a second therapeutic procedure (5 rigid bronchoscopies, 1 flexible brochoscopy). Complication rate was 4.87%: 2 cases of bronchitis. Group B presented a medium hospital stay of 1.34 +/- 0.27 days with a RSIE of 70.83%, needing a second intervention 7 children (4 fiberbonchoscopies, 3 rigid bronchoscopies). Postextraction complications in this group consisted of 1 bronchitis episode and a pneumothorax in 2 patients (8.33%). No deaths occurred in any group. No statistically significant differences were found in hospital stay, RSIE, type of second therapeutic procedure and complication rate.

CONCLUSIONS: Our experience shows that flexible bronchoscopy removal of airway foreign bodies is safe and efficient; therefore, we think that it should be taken into account as first choice method of treatment at any age.