The role of a transparent cap in the endoscopic removal of foreign bodies in the esophagus: A propensity score-matched analysis

J Dig Dis. 2020 Jan;21(1):20-28. doi: 10.1111/1751-2980.12833. Epub 2019 Dec 25.

Abstract

Objective: To investigate the effectiveness and safety of transparent cap-assisted endoscopy in removing foreign bodies in the esophagus.

Methods: Patients with foreign body lodged in the esophagus who received a transparent cap-assisted or conventional endoscopy between October 2004 and July 2018 were retrospectively enrolled. Propensity score matching was performed. The success rate of the endoscopic procedure, procedure time, clearness of endoscopic view and adverse event rate were compared between the two groups.

Results: Of the 838 patients who had a foreign body lodged in the esophagus, 728 (86.9%) underwent endoscopic intervention. After matched by prospensity score, 224 patients each received either transparent cap-assisted endoscopy or conventional endoscopy. No difference was noted between the two groups in terms of the success rate (100% vs 99.1%, P = 0.499). Transparent cap-assisted endoscopy was associated with shorter procedure time for removing jujube pits ([4.24 ± 2.81] min vs [7.62 ± 8.15] min, P = 0.001), fish bones ([2.99 ± 2.15] min vs [6.49 ± 6.54] min, P < 0.001) and other sharp objects ([4.29 ± 3.36] min vs [10.60 ± 19.79 min], P = 0.027) and higher rates of clear endoscopic views in extracting jujube pits, fish bones, poultry bones and other sharp objects (98% vs 43.4%, 97.5% vs 74.1%, 100% vs 81.3% and 100% vs 82.7%; all P < 0.05). No significant differences in the rates of adverse event were observed between the groups (P = 1.000).

Conclusion: Transparent cap-assisted endoscopic technique is effective and safe for removing sharp foreign bodies in the esophagus.

Keywords: cap; endoscopy; esophagus; foreign bodies; upper gastrointestinal tract.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Esophagoscopy / instrumentation*
  • Esophagoscopy / methods
  • Esophagus / surgery*
  • Female
  • Foreign Bodies / surgery*
  • Humans
  • Male
  • Middle Aged
  • Propensity Score
  • Retrospective Studies