Faculty of Medicine, University of Alberta, Edmonton, Canada.
Surg Endosc. 2011 Mar;25(3):919-22. doi: 10.1007/s00464-010-1299-0. Epub 2010 Aug 24.
Esophageal foreign body (FB) impaction is a common emergency in children. The goal of this study was to compare rigid versus flexible endoscopy in esophageal FB extraction in children.
In a retrospective cohort study with consecutive data, children with esophageal FB impaction who were admitted between January 2005 and December 2008 to the Stollery Children's Hospital, Edmonton, Canada, were included. Nature of the procedure for FB removal (flexible vs. rigid endoscopy), duration of the procedure, complications, and associated pathology were documented.
A total of 140 children were included (81 boys; mean age, 59.8 ± 48.6 (range, 4-203) months). More than half (54%) of patients were aged 3 years or younger. Coins were the most common foreign body (77.9%). Flexible endoscopy was used in 89 patients, rigid in 49, and both in 2 patients. The mean duration of the endoscopic procedure was 10.50 ± 12.2 minutes for FE (95% confidence interval (CI), 7.94-13.08) and 16.49 ± 21.1 minutes for RE (95% CI, 13.75-22.45; p = 0.04). Biopsies were taken in 19% of patients undergoing FE and in 6% of RE (p = 0.04).
Both rigid and flexible endoscopy techniques appear to be equally safe and effective in esophageal foreign body extraction. However, performing flexible endoscopy for esophageal foreign body takes a substantial shorter duration compared with rigid endoscopy. Flexible endoscopy would probably allow a better and more thorough examination and, hence, biopsying esophageal mucosa compared with rigid endoscopy.
食管异物（FB）嵌顿是儿童常见的急症。本研究旨在比较儿童食管 FB 取出时硬镜与软镜的效果。
本回顾性队列研究连续纳入 2005 年 1 月至 2008 年 12 月期间在加拿大埃德蒙顿斯特罗利儿童医院就诊的食管 FB 嵌顿患儿。记录 FB 取出的操作方式（软镜 vs. 硬镜）、操作时间、并发症和相关病理学情况。
共纳入 140 例患儿（81 例男性；平均年龄 59.8±48.6（4-203）月）。超过一半（54%）患儿年龄在 3 岁以下。最常见的异物是硬币（77.9%）。89 例患儿采用软镜，49 例采用硬镜，2 例采用两种内镜。软镜操作的平均时间为 10.50±12.2 分钟（95%置信区间：7.94-13.08），硬镜为 16.49±21.1 分钟（95%置信区间：13.75-22.45；p=0.04）。软镜组有 19%患儿行活检，硬镜组为 6%（p=0.04）。
硬镜和软镜技术在食管异物取出中均安全有效。但与硬镜相比，软镜用于食管异物取出的操作时间更短。与硬镜相比，软镜可能更有利于食管黏膜的全面、细致检查和活检。
