Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract in South China: A Retrospective Study of 561 Cases

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Abstract
Ingestion of a foreign body (FB) is a common occurrence; however, few studies have reported its characteristics and endoscopic management in South China. The aim of this study is to investigate the clinical features of FB ingestion in South China and report its management through endoscopy. Data were collected from all consecutive patients with suspected FB ingestion accepting endoscopic management in our endoscopy center during the past 10 years. The demographic data, clinical presentations, and endoscopic management were reviewed and analyzed retrospectively. A total of 561 patients with suspected FB ingestion underwent endoscopic management. Among them, 447 FBs were found in 439 (78.3%) patients. Fish bone ingestion was most common (60.4%). Most of the FBs were located in the esophagus (84.5%). The majority of patients (96.1%) were successfully treated with flexible endoscopy with the addition of suitable devices without any serious procedure-related complications. There was a significant difference in the types of FBs between the former and latter 5 years (P < 0.05), and fish bone ingestion became more prevalent with time. Compared with the conventional methods, a new technique with a reworked transparent cap was successful in dealing with small sharp FBs impacted at the entrance of esophagus. The new technique had a shorter operation time (11.7 versus 17.9 min, P = 0.02) and an increased success rate (by 8%). In South China, fish bone is the most common FB found in the upper gastrointestinal tract. Endoscopic management is a safe and effective approach in managing FBs. A new technique with reworked transparent cap is useful and promising, but further study is needed for confirmation.