Endoscopic removal of foreign bodies: A retrospective study in Japan

Kenji Jl Limpias Kamiya; Naoki Hosoe; Kaoru Takabayashi; Yukie Hayashi; Xi Sun; Ryoichi Miyanaga; Kayoko Fukuhara; Seiichiro Fukuhara; Makoto Naganuma; Atsushi Nakayama; Motohiko Kato; Tadateru Maehata; Rieko Nakamura; Koichi Ueno; Junichi Sasaki; Yuko Kitagawa; Naohisa Yahagi; Haruhiko Ogata; Takanori Kanai

doi:10.4253/wjge.v12.i1.33

Endoscopic removal of foreign bodies: A retrospective study in Japan

World J Gastrointest Endosc. 2020 Jan 16;12(1):33-41. doi: 10.4253/wjge.v12.i1.33.

Authors

Kenji Jl Limpias Kamiya¹, Naoki Hosoe², Kaoru Takabayashi³, Yukie Hayashi¹, Xi Sun³, Ryoichi Miyanaga¹, Kayoko Fukuhara³, Seiichiro Fukuhara³, Makoto Naganuma¹, Atsushi Nakayama⁴, Motohiko Kato⁴, Tadateru Maehata⁴, Rieko Nakamura⁵, Koichi Ueno⁶, Junichi Sasaki⁶, Yuko Kitagawa⁵, Naohisa Yahagi⁴, Haruhiko Ogata³, Takanori Kanai¹

Affiliations

¹ Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.
² Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan. nhosoe@z5.keio.jp.
³ Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan.
⁴ Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan.
⁵ Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
⁶ Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan.

Abstract

Background: The ingestion of foreign bodies (FBs) and food bolus impaction (FBI) in the digestive tract are commonly encountered clinical problems. Methods to handle such problems continue to evolve offering advantages, such as the avoidance of surgery, reduced cost, improved visualization, reduced morbidity, and high removal success rate. However, to date, no studies have evaluated the endoscopic management of FBs in Japan.

Aim: To elucidate level of safety and efficacy in the endoscopic management of FBs and FBI.

Methods: A total of 215 procedures were performed at Keio University Hospital between November 2007 and August 2018. Data were collected from medical charts, and endoscopic details were collected from an endoscopic reporting system. Procedures performed with a flexible gastrointestinal endoscope were only taken into account. Patients who underwent a technique involving FB or FBI from the digestive tract were only included. Data on patient sex, patient age, outpatient, inpatient, FB type, FB location, procedure time, procedure type, removal device type, success, and technical complications were reviewed and analyzed retrospectively.

Results: Among the 215 procedures, 136 (63.3%) were performed in old adults (≥ 60 years), 180 (83.7%) procedures were performed in outpatients. The most common type of FBs were press-through-pack (PTP) medications [72 (33.5%) cases], FBI [47 (21.9%)], Anisakis parasite (AP) [41 (19.1%) cases]. Most FBs were located in the esophagus [130 (60.5%) cases] followed by the stomach [68 (31.6%) cases]. AP was commonly found in the stomach [39 (57.4%) cases], and it was removed using biopsy forceps in 97.5% of the cases. The most common FBs according to anatomical location were PTP medications (40%) and dental prostheses (DP) (40%) in the laryngopharynx, PTP (48.5%) in the esophagus, AP (57.4%) in the stomach, DP (37.5%) in the small intestine and video capsule endoscopy device (75%) in the colon. A transparent cap with grasping forceps was the most commonly used device [82 (38.1%) cases]. The success rate of the procedure was 100%, and complication were observed in only one case (0.5%).

Conclusion: Endoscopic management of FBs and FBI in our Hospital is extremely safe and effective.

Keywords: Anisakis parasite; Endoscopic removal; Food bolus impaction; Foreign body; Grasping forceps.