A PROSPECTIVE RANDOMIZED TRIAL COMPARING THE USE OF THE FLEXIBLE GASTROSCOPE VERSUS THE BRONCHOSCOPE IN THE MANAGEMENT OF FOREIGN-BODY INGESTION

Background: Foreign body ingestion is a common clinical problem in Hon g Kong. Some recent reports have proposed the use of flexible nasoendo scopy for foreign body retrieval. The present study is a prospective r andomized trial on the use of the flexible gastroscope and bronchoscop e in the management of foreign body ingestion. Methods: Two hundred si xteen patients older than 11 years were prospectively randomized to fl exible endoscopic examination using either the gastroscope (108 patien ts) or the bronchoscope (108 patients). The duration of the procedure was noted. Patients were asked to assess their overall tolerance to th e procedure on a scale of 1 (well tolerated) to 10 (unacceptable). Res ults: A foreign body was retrieved in 68 patients (31.5%). There was n o difference between the two groups in the foreign body retrieval rate , type of foreign body retrieved, duration of procedure, and tolerance level. In the group managed with the bronchoscope, however, three pat ients required the additional use of the gastroscope for foreign body retrieval at (for one patient) or below (for two patients) the cricoph aryngeus. The patient's tolerance level was related only to the durati on of procedure (rho = 0.386; p < 0.001). Conclusion: The use of the f lexible gastroscope is recommended because of its efficacy, safety, an d tolerability.