Department for Paediatric Anaesthesia, Children's Hospital Cologne, Cologne, Germany.
Faculty for Health, University Witten/Herdecke, Witten, Germany.
Paediatr Anaesth. 2021 May;31(5):587-593. doi: 10.1111/pan.14158. Epub 2021 Feb 28.
Foreign bodies lodged in the upper esophagus in children may result in life-threatening complications, especially with button batteries. Rapid removal is essential to prevent complications. Experts report that extraction with a suitable laryngoscope and a forceps is feasible under general anesthesia, but no further data had been available so far.
To study foreign body visualization and removal from the upper esophagus in children using a new optimized Miller size 3 blade video laryngoscope.
This prospective observational study was performed in three pediatric hospitals. The clinical observations were reported anonymously on an electronic spreadsheet after obtaining the informed consent from the parents or guardians. During the observational period from January 2019 to October 2020, all children with a foreign body lodged into the upper esophagus were eligible for participation and 22 cases were included. Main outcome measures were rates of successful removal and complications as well as duration of the procedure. Secondary outcome was subjective assessment regarding the quality of the visualization and the feasibility of the procedure.
Success rate was 100% with no complications. Mean intervention and anesthesia times were 5 ± 4 minutes and 26 ± 25 minutes. Quality of visualization of the foreign body was judged as 'excellent' or 'good' in all cases and the feasibility of the procedure as 'without' or 'with little' effort in 95% of all cases.
The new Miller size 3 video laryngoscope enables rapid, easy, and reliable extraction of foreign bodies when they are located in the upper part of the esophagus. As early removal of esophageal foreign bodies, especially with button batteries, prevents life-threatening complications, we suggest this technique as the first choice of treatment.
儿童上食管内的异物可能导致危及生命的并发症，尤其是纽扣电池。快速取出异物至关重要，以防止并发症。专家报告，在全身麻醉下使用合适的喉镜和钳子提取是可行的，但迄今为止尚无其他数据。
使用新型优化的 Miller 3 号叶片视频喉镜研究儿童上食管内异物的可视化和取出。
本前瞻性观察性研究在三家儿科医院进行。在获得家长或监护人的知情同意后，将临床观察匿名报告在电子电子表格上。在 2019 年 1 月至 2020 年 10 月的观察期间，所有上食管内有异物的儿童均有资格参加，共纳入 22 例。主要观察指标为取出成功率和并发症发生率以及手术持续时间。次要观察指标是可视化质量和手术可行性的主观评估。
成功率为 100%，无并发症。平均干预和麻醉时间分别为 5 ± 4 分钟和 26 ± 25 分钟。所有病例的异物可视化质量均评为“优秀”或“良好”，95%的病例的手术可行性评为“无”或“稍有”困难。
新型 Miller 3 号视频喉镜可快速、轻松、可靠地提取位于食管上段的异物。由于早期取出食管异物，特别是纽扣电池，可预防危及生命的并发症，因此我们建议将该技术作为首选治疗方法。
