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    Emergent Endoscopy for Esophageal Foreign Body Removal: The Impact of Location.

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    Author
    Sagvand, Babak T
    Najafali, Daniel
    Yardi, Isha
    Sahadzic, Iana
    Afridi, Leenah
    Kohler, Alyssa
    Afridi, Ikram
    Kaur, Noorvir
    Tran, Quincy K
    Date
    2022-02-05
    Journal
    Cureus
    Publisher
    Cureus, Inc.
    Type
    Article
    
    Metadata
    Show full item record
    See at
    https://doi.org/10.7759/cureus.21929
    Abstract
    Background Timely intervention is essential for the successful removal of ingested foreign bodies. Emergent endoscopy (EGD) is usually performed in the emergency department (ED), operating room (OR), intensive care unit (ICU), or endoscopy suite. However, because the endoscopy suite is not always available, this study investigated the impact of location outside of the endoscopy suite on the successful removal of ingested foreign bodies and other patient outcomes. Methodology We reviewed charts of patients who underwent EGD for foreign body removal at an academic quaternary center between January 01, 2012, and December 31, 2020. We defined successful EGD as retrieval of the foreign body at the first attempt and not requiring subsequent endoscopy or surgical intervention. We performed descriptive and inferential statistical analyses and conducted classification and regression trees to compare endoscopy procedure length (EPL) and hospital length of stay (HLOS) between different locations. Results We analyzed 77 patients, of whom 13 (17%) underwent endoscopy in the ICU, 46 (60%) in the OR, and 18 (23%) in the ED. Endoscopic removal failed in four (5%) patients. Endoscopy length was significantly shorter in the OR (67 (48-122) minutes) versus the ICU (158 (95-166) minutes, P = 0.004) and the ED (111 (92-155) minutes, P = 0.009). Time to procedure was similar if the procedure was performed in the ED (278 minutes), the ICU (331 minutes), or the OR (378 minutes). The median (interquartile range) of HLOS for the OR group (0.87 (0.54-2.03) days) was significantly shorter than the ICU group (2.26 (1.47-6.91) days, P = 0.007). Conclusions While performing endoscopy for esophageal foreign body removal in the OR may be associated with a shorter EPL and HLOS, no location was inferior for overall outcomes. Further prospective and randomized studies are needed to confirm our findings.
    Rights/Terms
    Copyright © 2022, Sagvand et al.
    Keyword
    emergent endoscopy
    endoscopy
    esophageal foreign body
    food impaction
    location of endoscopy
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/18265
    ae974a485f413a2113503eed53cd6c53
    10.7759/cureus.21929
    Scopus Count
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