Safety of Surgical Removal of Aspirated Foreign Bodies after Failure of Bronchoscopy Removal

Abstract

Background: Foreign body (FB) aspiration is uncommon, but potentially serious and life-threatening. Foreign body aspiration represents about 0.5% of adult bronchoscopy procedures. When bronchoscopic removal fails, the procedure should stop and a thoracic surgeon must join the procedure, and the most common surgical strategy is lobectomy. Aims: The aim of this study is to describe the outcome and safety of surgical removal of aspirated foreign bodies through minimal thoracic surgery after failure of bronchoscopic removal. Materials and Methods: This is a descriptive hospital study that involved 21 patients hospitalized in two main hospitals in Khartoum, Sudan, between September 2013 and October 2019, for the surgical removal of aspirated foreign bodies. We collected data on the demographics and clinical characteristics of the patients, the nature and anatomical location of the foreign body, and the surgical results. Results: The mean age of the patients was 14 years and 12 of them were women. The incident was accidental in all patients, and the mean time between the foreign body aspiration and surgery was approximately 2 weeks. Foreign bodies were found in the right lung in 15 of the patients. All foreign body removals were achieved by minimally invasive thoracic surgery. In 17 patients, the surgery was conservative, but two patients underwent lobectomy and pneumonectomy was performed in 2 patients. The postoperative course was favorable in all patients and no deaths were reported Conclusion: Minimally invasive thoracic surgery in our setting has provided a safe approach to the removal of aspirated foreign bodies after failure of bronchoscopic removal.