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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 16, 2020; 12(1): 33-41
Published online Jan 16, 2020. doi: 10.4253/wjge.v12.i1.33
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
Kenji JL Limpias Kamiya, Yukie Hayashi, Ryoichi Miyanaga, Makoto Naganuma, Takanori Kanai, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
Naoki Hosoe, Kaoru Takabayashi, Xi Sun, Kayoko Fukuhara, Seiichiro Fukuhara, Haruhiko Ogata, Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, Tokyo 160-8582, Japan
Xi Sun, Department of Gastroenterology and Hepatology, Chinese PLA General Hospital, Beijing 100853, China
Atsushi Nakayama, Motohiko Kato, Tadateru Maehata, Naohisa Yahagi, Division of Research and Development for Minimally Invasive Treatment, Cancer Center, Keio University School of Medicine, Tokyo 160-8582, Japan
Rieko Nakamura, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan
Koichi Ueno, Junichi Sasaki, Department of Emergency and Critical Care Medicine, Keio University School of Medicine, Tokyo 160-8582, Japan
Author contributions: All authors helped to perform the research; Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, Ueno K, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contributed to drafting conception; Limpias Kamiya KJL, Hosoe N, Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, Ueno K, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contribution to design; Limpias Kamiya KJL, Hosoe N, Sasaki J, Kitagawa Y, Yahagi N, Ogata H, and Kanai T contribution to writing the manuscript; Limpias Kamiya KJL and Hosoe N performed procedures and analyzed the data; Takabayashi K, Hayashi Y, Sun X, Miyanaga R, Fukuhara K, Fukuhara S, Naganuma M, Nakayama A, Kato M, Maehata T, Nakamura R, and Ueno K contributed to performing the endoscopy.
Institutional review board statement: The present observational study was reviewed and approved by the ethics committee of Keio University Hospital (approval ID 20180281).
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All authors disclosed no financial conflict of interest relevant to this publication.
STROBE statement: The authors have read the Strobe statement-checklist of items, and the manuscript was prepared according to the Strobe statement.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Naoki Hosoe, FACG, MD, PhD, Associate Professor, Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine, 35 Shinanomachi, Shinjuku, Tokyo 160-8582, Japan. nhosoe@z5.keio.jp
Received: June 24, 2019
Peer-review started: June 26, 2019
First decision: August 2, 2019
Revised: August 9, 2019
Accepted: November 18, 2019
Article in press: November 18, 2019
Published online: January 16, 2020
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.
Core tip: The present study highlights the level of efficacy and safety in the removal of foreign bodies in Japan, using different devices avoiding any type of lesion of the digestive tract. Extractions of foreign body using flexible endoscopy were enrolled in the analysis. Press-through-pack medications was the most common FB, as it is commonly used in Japan. We used a large caliber soft oblique cap and grasping forceps and there was no complication in any of the cases. The level of safety and efficacy were excellent, therefore we recommend using devices used in this study.
