دورية أكاديمية
أعرض في EDS

Esophageal Bougienage for Management of Lodged Esophageal Coins: Safe, Effective, Efficient, and Underused.

التفاصيل البيبلوغرافية
العنوان: Esophageal Bougienage for Management of Lodged Esophageal Coins: Safe, Effective, Efficient, and Underused.
المؤلفون: Warner TN; From the Department of Emergency Medicine., Genereux M; Division of General Pediatrics, Department of Pediatrics., Price AB; Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC., Titus MO; Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC., Moake MM; Division of Pediatric Emergency Medicine, Department of Pediatrics, Medical University of South Carolina, Charleston, SC.
المصدر: Pediatric emergency care [Pediatr Emerg Care] 2022 Nov 01; Vol. 38 (11), pp. 589-597. Date of Electronic Publication: 2022 Sep 29.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Lippincott Williams & Wilkins Country of Publication: United States NLM ID: 8507560 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1535-1815 (Electronic) Linking ISSN: 07495161 NLM ISO Abbreviation: Pediatr Emerg Care Subsets: MEDLINE
أسماء مطبوعة: Publication: Hagerstown, MD : Lippincott Williams & Wilkins
Original Publication: Baltimore, Md. : Williams & Wilkins, [c1985-
مواضيع طبية MeSH: Numismatics* , Foreign Bodies*, Child ; Humans ; Esophagoscopy/methods ; Retrospective Studies ; Prospective Studies
مستخلص: Objectives: The aims of the study are to evaluate outcomes of esophageal bougienage for management of lodged esophageal coins and to assess the extent of bougienage usage and barriers among emergency providers.
Methods: We performed a retrospective chart review of pediatric patients with single lodged esophageal coins presenting to our single academic pediatric emergency department between November 2012 and December 2018. We compared procedural outcomes, complications, length of stay (LOS), and cost between those managed with bougienage and with endoscopy. We further surveyed emergency physicians to assess the extent of bougienage usage and barriers to utilization across different institutions.
Results: We identified 205 patients with single lodged esophageal coins presenting during our study window. One hundred forty-seven patients ultimately underwent bougienage with 97% success and no major complications. Fifty-six patients were managed by endoscopy with 100% success and one major complication. Bougienage had significantly lower LOS (median 2.18 vs 11.92 hours, P < 0.001) and hospital charges (median $3533 vs $12,679, P < 0.001) compared with endoscopy. We received 242 completed surveys representing 38 states from primarily academic pediatric emergency physicians. The majority of respondents (90%) used specialist consult with only 4.5% performing bougienage. A total of 36.4% of respondents had never heard of the procedure and only 16.1% had ever performed it. Barriers to usage included lack of provider training (95.6%), perceived risk of complications (94.4%), and perceived lack of success (80.5%).
Conclusions: Bougienage is safe and effective with significant LOS and cost benefits compared with endoscopy. Despite these advantages, the procedure is underused, because of lack of provider education and concerns regarding safety, efficacy, and both family and specialist preference, which are not supported by current literature. These data support the need for broader education regarding the bougienage technique, as well as larger prospective studies of its safety and outcomes.
Competing Interests: Disclosure: The authors declare no conflict of interest.
(Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.)
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تواريخ الأحداث: Date Created: 20220929 Date Completed: 20221102 Latest Revision: 20221102
رمز التحديث: 20231215
DOI: 10.1097/PEC.0000000000002849
PMID: 36173343
قاعدة البيانات: MEDLINE
الوصف
تدمد:1535-1815
DOI:10.1097/PEC.0000000000002849