Little Danny C, Shah Sohail R, St Peter Shawn D, Calkins Casey M, Morrow Stephen E, Murphy J Patrick, Sharp Ron J, Andrews Walter S, Holcomb George W, Ostlie Daniel J, Snyder Charles L
Department of Surgery, Children's Mercy Hospital, Kansas City, MO 64108, USA.
J Pediatr Surg. 2006 May;41(5):914-8. doi: 10.1016/j.jpedsurg.2006.01.022.
Children with esophageal foreign bodies are frequently seen by pediatric surgeons. Choking and dysphagia are common presentations; however, esophageal perforation has been reported. Historically, rigid esophagoscopy with extraction of the foreign body has been the recommended treatment. Alternatively, Foley balloon extraction is a safe and effective approach.
Over a 16-year period, 555 children presented with an esophageal foreign body. Retrospective analysis of the medical record was undertaken. Statistics were by univariate analysis.
Two hundred ninety-eight boys and 257 girls presented with a mean age of 3.24 years. Dysphagia (37%) and drooling (31%) were the most common symptoms. Foreign bodies were lodged in the superior esophagus in 73%, and 88% of the objects were coins. Balloon extraction with fluoroscopy was performed in 468 children. Eighty percent of the objects were successfully removed with a mean fluoroscopy time of 2.2 min, and 8% were advanced into the stomach. The overall success rate was 88%, with failures necessitating rigid esophagoscopy under general anesthesia. Children younger than 1 year were the most likely to fail (25% failure rate). Airway aspiration never occurred. Significant savings in patient charges were observed with this approach.
Balloon extraction of pediatric esophageal foreign bodies is a safe and cost-effective procedure. This technique is applicable for infants, children, and adolescents. Experienced practitioners should be able to achieve greater than 80% success rate.
小儿外科医生经常会遇到食管异物的患儿。窒息和吞咽困难是常见症状；不过，也有食管穿孔的报道。从历史上看，推荐的治疗方法是硬式食管镜检查并取出异物。另外， Foley 球囊取出法是一种安全有效的方法。
在16年的时间里，有555名患儿出现食管异物。对病历进行回顾性分析。采用单因素分析进行统计。
共有298名男孩和257名女孩，平均年龄3.24岁。吞咽困难（37%）和流口水（31%）是最常见的症状。73%的异物嵌顿在上段食管，88%的异物是硬币。468名患儿采用了透视下球囊取出法。80%的异物成功取出，平均透视时间为2.2分钟，8%的异物进入胃内。总体成功率为88%，失败的患儿需要在全身麻醉下进行硬式食管镜检查。1岁以下的患儿最容易失败（失败率为25%）。从未发生气道误吸。采用这种方法可显著节省患者费用。
小儿食管异物的球囊取出法是一种安全且具有成本效益的方法。该技术适用于婴儿、儿童和青少年。经验丰富的从业者应能取得超过80%的成功率。
