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[How to reduce the incidence of complication and mortality in pediatric tracheobronchial foreign body patients].

OBJECTIVE
To analyze the experience for the diagnosis and treatment of pediatric tracheobronchial foreign body cases, so to the incidence of complications and mortality.


METHODS
7260 tracheobronchial foreign body cases, from 1987 through 2003, were enrolled in this study. Early diagnosis, preoperative evaluation and perioperative treatment were strongly emphasized in this group of patients.


RESULTS
7618 patients received rigid bronchoscopy and 7260 cases were confirmed with tracheobronchial foreign bodies. The confirmed diagnosis rate is 95.3%. Among the 7260 cases, 7007 (96. 4% ) patients were diagnosed and received bronchoscopic foreign body removal within 24 hours. Different food is the most common foreign body aspirated in infants and toddlers (under 4 year old), whereas older children are more likely to aspirate other foreign bodies. Peanuts and sunflower seed (6862) were noted as the most common ones. Pen caps (398) are much less. All patients were evaluated before surgery after 1996. Complications occurred in 7 patients (0.1%) . The mortality rate is zero. 7165 cases' foreign body were successfully removed the first time of brochoscopy. 95 patients received more than one times bronchoscopy. 67 cases' foreign bodies were smoothly removed with second bronchoscopy. 16 cases received flexible bronchoscopic foreign body removal when rigid bronchoscopic procedure failed. 12 cases received chest surgery for foreign body removal. 6933 cases received bronchoscopy with surface anesthesia or without anesthesia, while 327 patients with general anesthesia combined local surface anesthesia.


CONCLUSIONS
Rapid diagnosis and treatment can reduce the complication and mortality rate. So that early diagnosis, preoperative evaluation and perioperative treatment should be strongly emphasized.