Clinical experiences of removing foreign bodies in the airway and esophagus with a rigid endoscope: A series of 3217 cases from 1970 to 1996

2000 ◽  
Vol 122 (3) ◽  
pp. 450-454 ◽  
Author(s):  
Wei-Chung Hsu ◽  
Tzung-Shiahn Sheen ◽  
Chia-Der Lin ◽  
Ching-Ting Tan ◽  
Te-Huei Yeh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Complication Rate ◽  
Foreign Bodies ◽  
University Hospital ◽  
Significant Finding ◽  
Direct Visualization ◽  
Endoscopic Removal ◽  
Clinical Experiences ◽  
Rigid Endoscopy ◽  
Animal Bones

This study examined 11,333 rigid endoscopy procedures performed in the Department of Otolaryngology, National Taiwan University Hospital, during a 27-year period from 1970 to 1996. Among these cases, 3217 were performed to remove foreign bodies from the airway (459 cases, 14.3%) and esophagus (2758 cases, 85.7%). Retrospective analysis of these data revealed that peanuts (217 cases) and animal bones (1184 cases) were the most frequent foreign bodies encountered in the airway and esophagus, respectively. The successful rate of removal of these foreign bodies was 99.9% (3213/3217). The complication rate was only 0.2% (8/3217), and the mortality rate was less than 0.1% (2/3217). On the basis of these results, we conclude that foreign bodies in the airway and esophagus can be removed safely under direct visualization through rigid endoscopy with relatively few complications. A significant finding in this study is the declining trend in the number of cases in recent years. Despite the decline in the number of procedures, endoscopic removal of foreign bodies remains as a vital skill of the aerodigestive tract surgeon.

Clinical Experiences of Removing Foreign Bodies in the Airway and Esophagus with a Rigid Endoscope: A Series of 3217 Cases from 1970 to 1996

2000 ◽  
Vol 122 (3) ◽  
pp. 450-454 ◽  
Author(s):  
Wei-Chung Hsu ◽  
Tzung-Shiahn Sheen ◽  
Chia-Der Lin ◽  
Ching-Ting Tan ◽  
Te-Huei Yeh ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Complication Rate ◽  
Foreign Bodies ◽  
University Hospital ◽  
Significant Finding ◽  
Direct Visualization ◽  
Endoscopic Removal ◽  
Clinical Experiences ◽  
Rigid Endoscopy ◽  
Animal Bones

This study examined 11,333 rigid endoscopy procedures performed in the Department of Otolaryngology, National Taiwan University Hospital, during a 27-year period from 1970 to 1996. Among these cases, 3217 were performed to remove foreign bodies from the airway (459 cases, 14.3%) and esophagus (2758 cases, 85.7%). Retrospective analysis of these data revealed that peanuts (217 cases) and animal bones (1184 cases) were the most frequent foreign bodies encountered in the airway and esophagus, respectively. The successful rate of removal of these foreign bodies was 99.9% (3213/3217). The complication rate was only 0.2% (8/3217), and the mortality rate was less than 0.1% (2/3217). On the basis of these results, we conclude that foreign bodies in the airway and esophagus can be removed safely under direct visualization through rigid endoscopy with relatively few complications. A significant finding in this study is the declining trend in the number of cases in recent years. Despite the decline in the number of procedures, endoscopic removal of foreign bodies remains as a vital skill of the aerodigestive tract surgeon.

scholarly journals Characteristics of fish-bone foreign bodies in the upper aero-digestive tract: The importance of identifying the species of fish

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255947
Author(s):  
Tadahisa Shishido ◽  
Jun Suzuki ◽  
Ryoukichi Ikeda ◽  
Yuta Kobayashi ◽  
Yukio Katori
Keyword(s):  
Foreign Body ◽  
Digestive Tract ◽  
Fish Species ◽  
Foreign Bodies ◽  
Age Distribution ◽  
Fish Bone ◽  
University Hospital ◽  
Surgical Removal ◽  
Endoscopic Removal ◽  
Fish Bones

Background Fish bones are common foreign bodies in the upper aero-digestive tract, but their clinical features in relation to fish species have not been confirmed. We aimed to clarify the clinical characteristics of fish-bone foreign bodies and their location and removal methods depending on the fish species. Study design Retrospective, observational, monocentric study. Methods From October 2015 to May 2020, 368 patients visited the Department of Otolaryngology-Head and Neck Surgery at Tohoku University Hospital complaining of dysphagia, sore throat, or pharyngeal discomfort after eating fish. We analyzed the patients’ sex and age distribution, foreign-body location, type of the fish, and the techniques used for removing the foreign body. Results Fish bones were confirmed in the upper aero-digestive tract in 270 cases (73.4%), of which 236 (87.4%) involved fish-bone foreign bodies in the mesopharynx. The most frequently involved site was the palatine tonsil (n = 170). Eel was the most frequently observed fish species (n = 39), followed by mackerel (n = 33), salmon (n = 33), horse mackerel (n = 30), and flounder (n = 30). Among the 240 cases in which the bones did not spontaneously dislocate, 109 (45.4%) were treated by endoscopic removal (103 cases) or surgery (6 cases). In pediatric cases (<12 years old), almost all fish bones were found in the mesopharynx (138/139, 99.3%), and 31 cases (22.3%) required endoscopic removal. Flounder fish bones were often lodged in the hypopharynx and esophagus (9/30, 30%), hindering spontaneous dislocation and frequently necessitating endoscopic or surgical removal (19/29, 65.5%). Conclusion The characteristics of fish-bone foreign bodies differed depending on the fish species. Flounder bones were often stuck in the hypopharynx and esophagus and were likely to require more invasive removal methods. Confirming the species of the fish could facilitate appropriate diagnosis and treatment of fish-bone foreign bodies.

CLINICAL AND PARACLINICAL CHARACTERISTICS AND RESULTS FROM TREATMENT OF FOREIGN BODIES INGESTION

2016 ◽  
pp. 63-69
Author(s):  
Hoang Cuong Vo ◽  
Thanh Dang ◽  
Phuong Nam Tran ◽  
Thanh Thai Le
Keyword(s):  
Foreign Body ◽  
Clinical Characteristics ◽  
Foreign Bodies ◽  
University Hospital ◽  
Age Group ◽  
Central Hospital ◽  
Results Of Treatment ◽  
Rigid Esophagoscopy ◽  
Flexible Esophagoscopy ◽  
Esophageal Foreign Bodies

Background: Foreign bodies ingestion is a emergency in otology, knowledge of people about foreign bodies ingestion is not enough. Objective: To study the clinical characteristics, paraclinical characteristics and results of treatment from foreign bodies ingestion in Hue Central Hospital and Hue University Hospital. Methods and patiens: A cross descriptive and prospective study over the period from 6/2014 to 5/2016, total are 137 patients come to be diagnosised and treatmented. Results: the average age is 35 years old. Gender: male (51.8%) and women (48.2%). Adults (84.7%) having more than children (15.3%). Age group from 16-30 years is highest (32.8%). There are 95.7% of organic foreign bodies, 4.3% are inorganic foreign bodies. There are 90.5% of patients on diagnosis and treatment in stages less inflammation, arthritis 8.0% in the period and 1.5% in the period complications. Foreign body in the throat problems (73.7%), esophageal foreign bodies (26.3%). Pick up directly foreign bodies 54%, indirectly by the mirror 11.7% and endoscopy 8%, rigid esophagoscopy is 17.5%, flexible esophagoscopy is 7.3%, cervicotomy is 1.5%. Conclusion: Practing direction with in the oropharynx foreign body, using the larynx mirror or endoscopy with in the laryngopharynx for the esophagus foreign bodies, rigid esophagoscopy is better. Key words: Foreign bodies ingestion

Effectiveness of a vancomycin dosing protocol guided by area under the concentration-time curve to minimal inhibitory concentration (AUC/MIC) with multidisciplinary team support to improve hospital-wide adherence to a vancomycin dosing protocol: A pilot study

2021 ◽  
pp. 1-6
Author(s):  
Panipak Katawethiwong ◽  
Anucha Apisarnthanarak ◽  
Kittiya Jantarathaneewat ◽  
David J. Weber ◽  
David K. Warren ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Multidisciplinary Team ◽  
Kidney Injury ◽  
University Hospital ◽  
Routine Practice ◽  
Post Intervention ◽  
Coagulase Negative Staphylococci ◽  
Time Curve ◽  
Concentration Time ◽  
Quasi Experimental

Abstract Background: Limited data are available on the implementation of an area under the concentration-time curve (AUC)–based dosing protocol with multidisciplinary team (MT) support to improve adherence with vancomycin dosing protocol. Objective: To evaluate the effectiveness of an AUC-based dosing protocol with MT support intervention with adherence to a hospital-wide vancomycin dosing protocol at Thammasat University Hospital. Method: We conducted a quasi-experimental study in patients who were prescribed intravenous vancomycin. The study was divided into 2 periods; (1) the preintervention period when the vancomycin dosing protocol was already applied in routine practice and (2) the post-intervention period when the implementation of an AUC-based dosing protocol with MT support was added to the existing vancomycin dosing protocol. The primary outcome was the rate of adherence, and the secondary outcomes included acute kidney injury events, vancomycin-related adverse events, and 30-day mortality rate. Results: In total, 240 patients were enrolled. The most common infections were skin and soft-tissue infections (24.6%) and bacteremia (24.6%). The most common pathogens were coagulase-negative staphylococci (19.6%) and Enterococcus spp (15.4%). Adherence with the vancomycin dosing protocol was significantly higher in the postintervention period (90.8% vs 55%; P ≤ .001). By multivariate analysis, an AUC-based dosing protocol with MT support was the sole predictor for adherence with the vancomycin dosing protocol (adjusted odds ratio, 10.31; 95% confidence interval, 4.54–23.45; P ≤ .001). The 30-day mortality rate was significantly lower during the postintervention period (8.3% vs 20%; P = .015). Conclusions: AUC-based dosing protocol with MT support significantly improved adherence with vancomycin dosing protocol and was associated with a lower 30-day mortality rate.

Prospective review of a single center's general pediatric neurosurgical intraoperative and postoperative complication rates

2014 ◽  
Vol 13 (1) ◽  
pp. 107-113 ◽  
Author(s):  
Erik J. van Lindert ◽  
Hans Delye ◽  
Jody Leonardo
Keyword(s):  
Mortality Rate ◽  
Adverse Events ◽  
Postoperative Complication ◽  
Complication Rate ◽  
Surgical Procedure ◽  
Neurosurgical Procedures ◽  
Complication Rates ◽  
Tumor Surgery ◽  
Infection Rates ◽  
Targeted Interventions

Object The authors conducted a study to compare the complication rate (CR) of pediatric neurosurgical procedures in a general neurosurgery department to the CRs that are reported in the literature and to establish a baseline of CR for further targeted improvement of quality neurosurgical care. Methods The authors analyzed the prospectively collected data from a complication registration of 1000 consecutive pediatric neurosurgical procedures in 581 patients from the beginning of the registration in January 2004 through August 2008. A pediatric neurosurgeon was involved in 50.5% of the procedures. All adverse events (AEs) from induction of anesthesia until 30 days postoperatively were recorded. Results Overall, 229 complications were counted in 202 procedures. The overall CR was 20.2%, with a 2.7% intraoperative CR and a 17.5% postoperative CR. Tumor surgery was associated with the highest CR (32.7%), followed by CSF disorders (21.8%). The mortality rate was 0.3%. An unplanned return to the operating room in relation to an AE happened in 10.5% of all procedures and in 52% of procedures associated with AEs, the majority of which were related to CSF disorders. Conclusions The CR in pediatric neurosurgical procedures was significant, and more than half of the patients with an AE required a repeat surgical procedure. Analysis of CRs should be a prerequisite for the prevention of complications and for the development of targeted interventions to reduce the CR (for example, infection rates).

A New Protector Device for Safe Endoscopic Removal of Sharp Gastroesophageal Foreign Bodies in Infants

1993 ◽  
Vol 16 (4) ◽  
pp. 393-396 ◽  
Author(s):  
Giorgio Bertoni ◽  
Dario Pacchione ◽  
Romano Sassatelli ◽  
Enrico Ricci ◽  
Maria G. Mortilla ◽  
...  
Keyword(s):  
Foreign Bodies ◽  
Endoscopic Removal

scholarly journals Liver and Pancreatic Resection in the Elderly

HPB Surgery ◽  
1997 ◽  
Vol 10 (4) ◽  
pp. 259-261 ◽  
Author(s):  
O. J. Garden
Keyword(s):  
Survival Rate ◽  
Liver Resection ◽  
Mortality Rate ◽  
Elderly Patients ◽  
Complication Rate ◽  
Pancreatic Resection ◽  
The Elderly ◽  
Term Survival ◽  
Pancreatic Resections

Background: Liver resection, or pancreaticoduodenectomy, has traditionally been thought to have a high morbidity and. mortality rate among the elderly. Recent improvements in surgical and anesthetic techniques, an increasing number of elderly patients, and an increasing need to justify use of limited health care resources prompted an assessment of recent surgical outcomes.Methods: Five hundred seventy-seven liver resections (July 1985–July 1994) performed for metastatic colorectal cancer and 488 pancreatic resections (October 1983–July 1994) performed for pancreatic malignancies were identified in departmental data bases. Outcomes of patients younger than age 70 years were compared with those of patients age 70 years or older.Results: Liver resection for 128 patients age 70 years or older resulted in a 4% perioperative. mortality rate and a 42% complication rate. Median hospital stay was 13 days, and 8% of the patients required admission to the intensive care unit (ICU). Median survival was 40 months, and the 5-year survival rate was 35%. No difference were found between results for the elderly and those for younger patients who had undergone liver resection, except for a minimally shorter hospital stay fortheyoungerpatients (median, 12 days vs. 13 days p=0.003). Pancreatic resection for 138 elderly patients resulted in a mortality rate of 6% and a complication rate of 45%. Median stay was 20 days, and 19% of the patients required ICU admission, results identical to those for the younger cohort. Long-term survival was poorer for the elderly patients, with a 5-year survival rate of 21% compared with 29% for the younger cohort (p=0.03).Conclusions: Major liver or pancreatic resections can be performed for the elderly with acceptable morbidity and mortality rates and possible long-term survival. Chronologic age alone is not a contraindication to liver or pancreatic resection for malignancy.

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