소아 식도 이물 적출 방법 변화에 관한 연구
(The) Study on Trend in Endoscopic Removal Methods of Esophageal Foreign Body in Children
소아 식도이물적출 이물적출 의학;
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Purpose: The aim of this study was to evaluate the type of esophageal foreign body and the latest tendency of esophageal foreign body's extraction and to obtain a consensus from recent trends of indications and techniques of flexible endoscopy of esophageal foreign body in children. Methods: We retrospectively reviewed medical records of 127 cases with foreign bodies in esophagus at Dept. of Pediatric and Otorhinolaryngology, Gyeongsang National University Hospital from Jun, 1987 to July, 2001. They were divided into two groups by the kinds of endoscopy: flexible endoscope(66 cases) or rigid endoscope(61 cases). Rigid endoscopy was performed under general anesthesia at Dept. of Otorhinolaryngology but flexible endoscopy was performed without general anesthesia or sedative drugs ). Results: An annual number of cases of two groups were similar from 1991 to 1998. But from 1999, flexible endoscopy was performed actively. In both groups, the most common peak age was between 1-5 years, males were prevalent and the most common foreign bodies were coins. Asymptomatic cases were frequently observed in flexible endoscopy(28 cases/66 cases) but swallowing difficulties were frequently observed in the rigid endoscopy group(25 cases/61 cases). Other symptoms were vomiting, irritability, chest discomfort and abdominal pain. The total number of cases with underlying diseases(esophageal stenosis 5, cerebral palsy 3) was 8. The total number of cases with complications(erosion 7, ulcer 1, bleeding 2, perforation 1) was 11. The above cases were not correlated between the two groups. In 55 cases(83.3%) of the flexible endoscopic group and 53 cases(86.8%) of the rigid endoscopic group, foreign bodies in the esophagus were removed within 24 hours. Conclusion: We could not find any benefit in rigid endoscopic technique. Flexible endoscopy was easily performed without general anesthesia. Flexible endoscopic foreign body removal can be performed safely and effectively in children by an experienced endoscopist.