AN EXPERIENCE OF BRONCHOTOMY AND RESECTIONAL PROCEDURES AFTER FAILED BRONCHOSCOPIC FOERIGN BODY RETRIEVAL
AbstractBackground: Foreign body bronchus is a surgical emergency and is associated with a high mortality if neglected or complicated. The objective of this study was to analyse the outcome of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval. Methods: This study of 24 cases of bronchotomy and resectional procedures after failed bronchoscopic foreign body retrieval was done from June 2008 to June 2009 and March 2010 to Sep 2013. Patients after failed retrieval of foreign body by bronchoscopy either by ENT specialists or thoracic surgeons underwent bronchotomy or resectional procedures were included in the study. We used the posterolateral thoracotomy approach for the surgical procedures. Results: Bronchotomy and resectional procedures were done in 24 cases. Age of patients ranged from 2 years to 51 years. Most patients were children and right side was mostly involved. Bronchotomy procedures were 10 (41%) and resectional surgeries were 13 (58%). Emergency lobectomies were 3 out of 13 resectional surgeries. Right intermedius bronchus was opened up and incision was extended in the direction of foreign body in 6 cases and left bronchus intermedius was opened in 4 cases. Haemoptysis was the main symptom in late presenters. Range of objects retrieved in our study was from pins, needles to whistles. Conclusion: Retention causes endobronchial obstruction with stasis leading to irreversible damaged parenchyma. Foreign body with structural changes require resection, others can be offered bronchotomy which is a safe procedure for retained non retrievable foreign bodies.Keywords: Outcome, resectional procedures, early and delayed presentation
Oncel M, Sunam GS, Ceran S. Tracheobronchial aspiration of foreign bodies and rigid bronchoscopy in children. Pediatr Int 2012;54(4):532–5.
Ciftci AO, Bing-Kolo, Senocak ME, Tanyel FC, Büyükpamukçu N. Bronchoscopy for evaluation of foreign body aspiration in children. J Pediatr Surg 2003;38(8):1170–6.
Tomaske M, Gerber AC, Weiss M. Anesthesia and periinterventional morbidity of rigid bronchoscopy for tracheobronchial foreign body diagnosis and removal. Paediatr Anaesth 2006;16(2):123–9.
Oliveira CF, Almeida JF, Troster EJ, Vaz FA. Complications of tracheobronchial foreign body aspiration in children . Rev Hosp Clin Fac Med Sao Paulo 2002;57(3):108–11.
Langer D, Petermann C, Lübbers H, Lankisch PG. Relapsing pneumonia due to a migrating intrathoracic foreign body in a World War II veteran shot 53 years ago. J Intern Med 1999;245(4):405–7.
Ugrinović AB, Djukić VB, Erdevicki LV, Arsenijević SD, Milovanović JP, Andrić SD, et al. Foreign bodies of the lower respiratory tract. Acta Chir Iugosl 2009;56(3):127–30.
Cataneo AJ, Reibscheid SM, Ruiz Júnior RL, Ferrari GF. Foreign body in the tracheobronchial tree. Clin Pediatr (Phila) 1997;36(12):701–6.
Li Y, Wu W, Yang X, Li J. Treatment of 38 cases of foreign body aspiration in children causing life-threatening complications. Int J Pediatr Otorhinolaryngol. 2009;73(12):1624–9.
Elhassani NB. Tracheobronchial foreign bodies in the Middle East. A Baghdad study. J Thorac Cardiovasc Surg 1988;96(4):621–5.
Hamilton AH, Carswell F, Wisheart JD. The Bristol Children's Hospital experience of tracheobronchial foreign bodies .Bristol Med Chir J 1989;104(3):72–4.
Krifa N, Belcadhi M, Mani R, Abdelkefi M, Bouzouita K. Bronchoscopic findings in children with prolonged respiratory symptoms. Rev Laryngol Otol Rhinol (Bord) 2009;130(2):111–5.
Ma G, Yang J, Liu S. Anesthetic management of bronchial rupture following extraction of a fishbonefrom the bronchus after 5 months. Paediatr Anaesth 2014;24(5):544–6.
Xu EM, Xu ZQ, Wang ZN, Wang Y, Chen P, Zhang YM, et al. Experience in the removal of difficult and high risk tracheobronchial foreign body by bronchoscopy. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2012;47(12):982–6.
Pattison CW, Leaming AJ, Townsend ER. Hidden foreign body as a cause of recurrent hemoptysis in a teenage girl. Ann Thorac Surg 1988;45(3):330-1.
Linehan L, Hinchion J, O'Connor TM.Empyema thoracis from an inhaled peanut. BMJ Case Rep 2014;2014:bcr2014203579.
Moura e Sá J, Oliveira A, Caiado A, Neves S, Barroso A, Almeida J, et al. Tracheobronchial foreign bodies in adults--experience of the Bronchology Unit of Centro Hospitalar de Vila Nova de Gaia. Rev Port Pneumol 2006;12(1):31–43.
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.