Background and Aim

The use of a transparent cap has been found to be effective for retrieval of an esophageal foreign body. However, data on the use of a cap in food bolus obstruction (FBO) are limited. This study aims to assess the effectiveness of a cap-assisted technique compared with conventional techniques in removal of FBO.

Methods

All patients who underwent an endoscopy for boneless FBO between 2011 and 2016 were prospectively recruited. The measured outcomes were procedure time, success rate of food bolus (FB) extraction, rate of en bloc removal, procedure-related adverse events, and length of hospital stay (LOS) between the 2 groups.

Results

Of the 315 patients who had an endoscopy for FBO, 48 (15.2%) had spontaneous passage of FB and 267 (84.8%) had impacted FB. Sixty-eight (25%) patients had the “push” maneuver, and 199 (75%) patients had the “pull” maneuver to remove FB. Of those who had the “pull” maneuver, a cap was used for 93 and conventional device(s) for 106. The use of a cap was associated with a shorter procedural time (34.3 ± 8.0 minutes versus 43.3 ± 22.6 minutes, P = .003), a higher rate of en bloc removal (87.3% versus 22.8%, P < .001), a lower rate of adverse events (0/93 versus 7/106, P = .01), and a shorter LOS (1.0 ± 0.6 days versus 1.6 ± 1.4 days, P = .0017).

Conclusion

The cap-assisted technique has been found to be effective and safe in removal of esophageal FBO. This technique was associated with a shorter procedural time and a reduced LOS compared with conventional techniques. However, these findings require further validation in a randomized control study.

中文翻译：

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帽辅助装置在内窥镜下从食道清除食物团阻塞的有效性

背景与目标

已经发现使用透明帽对于食道异物的恢复是有效的。但是，有关在食物团阻塞（FBO）中使用上限的数据是有限的。这项研究旨在评估帽辅助技术与传统技术相比在去除FBO方面的有效性。

方法

前瞻性招募了2011年至2016年接受无骨FBO内窥镜检查的所有患者。测量的结果是两组之间的手术时间，食物推注（FB）提取成功率，整组切除率，与手术相关的不良事件以及住院时间（LOS）。

结果

在315例接受FBO内窥镜检查的患者中，48例（15.2％）发生了自发性FB，而267例（84.8％）受到了FB的影响。六十八（25％）位患者进行了“推”动作，而199位（75％）患者进行了“推”动作以去除FB。在进行“拉动”操作的人员中，有93人使用了顶盖，而使用常规装置的是106人。使用顶盖的操作时间更短（34.3±8.0分钟与43.3±22.6分钟，P  = .003），整体清除率较高（87.3％对22.8％，P  <.001），不良事件发生率较低（0/93对7/106，P  = .01）和LOS较短（ 1.0±0.6天与1.6±1.4天，P  = .0017）。

结论

业已发现，帽辅助技术可有效，安全地去除食管FBO。与传统技术相比，该技术可缩短手术时间并降低LOS。但是，这些发现需要在随机对照研究中进一步验证。