Objective: This study aims to describe the clinicodemographic profile of patients with foreign bodies in the upper aerodigestive tract and their treatment outcomes. Methods: Design: Retrospective review of records. Setting: Tertiary Government Training Hospital. Participants: Records of 304 patients diagnosed with aerodigestive foreign bodies Results: Three hundred-four (304) patients were included. The median age was 5.26 years in the pediatric age group and 42.53 years in the adult age group, with a male-to female ratio = 1.97:1. Foreign bodies were ingested in 291 (96%) patients while aspiration occurred in 13 (4%). Overall, 211 (69%) of cases involved the pediatric population (<19 years) and 93 (31%) the adult population. The most common foreign bodies reported were coins (63.5%), food (18.1%), and dentures (11.5%). Most esophageal foreign bodies (244/291; 83%) were seen at the cricopharyngeal level in all age groups. The foreign body was removed successfully in 288/291 (98%) of ingestion cases. All 13 cases of foreign body aspiration were successfully removed by bronchoscopy. All patients were discharged improved. Conclusion Most upper aerodigestive tract foreign bodies involved the pediatric age group. Predisposing conditions were mainly due to accidental ingestion and aspiration while playing in the pediatric population and negligence in eating among adults. Almost all ingestion cases were successfully treated with esophagoscopy, while all aspirations were treated successfully with bronchoscopy. Most intraoperative and postoperative complications who were managed conservatively by observation, although some cases required referral to other surgical departments and were treated surgically. All patients were discharged improved.
Foreign Bodies ; Eating ; Esophagoscopy ; Bronchoscopy

OBJECTIVES: To investigate the clinical application of metagenomic next-generation sequencing (mNGS) of bronchoalveolar lavage fluid (BALF) in the etiological diagnosis and treatment of refractory pneumonia (RTP) in children. METHODS: A retrospective analysis was performed on 160 children with RTP who were admitted to the Department of Pediatric Internal Medicine, Maternal and Child Health Hospital of Inner Mongolia Autonomous Region, from January 2020 to March 2023. According to whether mNGS was performed, they were divided into two groups: mNGS (n=80) and traditional testing (n=80). All children received the tests of inflammatory markers and pathogen tests after admission. Traditional pathogenicity tests included microbial culture (sputum specimen collected by suction tube), nucleic acid detection of respiratory pathogens, and serological test (mycoplasma, tuberculosis, and fungi). For the mNGS group, BALF specimens were collected after bronchoscopy and were sent to the laboratory for mNGS and microbial culture. The two groups were analyzed and compared in terms of the detection of pathogens and treatment. RESULTS: Compared with the traditional testing group, the mNGS group had a significantly higher detection rate of pathogens (92% vs 58%, P<0.05), with more types of pathogens and a higher diagnostic rate of mixed infections. Compared with the traditional testing group, the mNGS group had a significantly higher treatment response rate and a significantly lower incidence rate of complications during hospitalization (P<0.05). Treatment was adjusted for 68 children in the mNGS group according to the results of mNGS, with a treatment response rate of 96% (65/68) after adjustment. CONCLUSIONS Compared with traditional pathogen tests, BALF mNGS can significantly improve the detection rate of pathogens and find some rare pathogens. In clinical practice, when encountering bottlenecks during the diagnosis and treatment of children with RTP, it is advisable to promptly perform the mNGS to identify the pathogens.
Humans ; Child ; Bronchoalveolar Lavage Fluid ; Retrospective Studies ; Pneumonia/therapy* ; High-Throughput Nucleotide Sequencing ; Bronchoscopy ; Sensitivity and Specificity

This paper focuses on the diagnosis and treatment of disorders of laryngeal airway in children, including congenital anomalies, infection, and tumor of the larynx to provide a new technology for managing these diseases. Based on the characteristic of them, the pediatric upper airway is dedicated to the clinical evaluation of airway obstruction and the assessment of the compromised pediatric airway, including clinical evaluation of symptoms, diagnostic endoscopy, and imaging examination. Information on endoscopic techniques used for dealing with different degrees of pediatric airway comprised is provided, also this techniques could diagnose what kinds of airway disorder. For example, determining the a particular laryngeal cleft at the initial otolaryngology encounter, flexible laryngoscopy should be performed. In order to define the extent of any identified cleft, the rigid bronchoscopy should be completed to evaluate for classification of laryngeal cleft including typeⅠ, Ⅱ, Ⅲa, Ⅲb, Ⅳa, Ⅳb under general anesthesia. The decision to pursue any therapy for the disorders of laryngeal airway in children should be based on the severity of the patient's symptoms, endoscopic and imaging examination. There are two medical treatments including nonsurgical therapy and surgical therapy. For example the laryngeal cleft, approximately half of type 1 and select type 2 patients can be managed entirely with nonsurgical therapy. Medical management is multifaceted. Under recommendations from the feeding team, a modified diet with thickened feeds and possibly altered feeding position should be initiated. Endoscopic surgical repair is the current gold standard for definitive repair of type 1, the majority of type 2, and selected type 3 clefts. Finally, information on new techniques used into the future for dealing with the diagnosis and treatment of disorders of laryngeal airway in children in this paper.
Child ; Humans ; Infant ; Larynx/surgery* ; Laryngoscopy ; Endoscopy ; Bronchoscopy ; Congenital Abnormalities/surgery*

OBJECTIVES: To study the role of bronchoscopy in slide tracheoplasty. METHODS: A retrospective analysis was conducted on the diagnosis and treatment of four children with tracheal stenosis admitted to Hunan Provincial People's Hospital from 2017 to 2020. The role of bronchoscopy was summarized in the preoperative evaluation, intraoperative positioning and measurement, and postoperative wound evaluation and treatment during slide tracheoplasty. RESULTS: Bronchoscopy evaluation before slide tracheoplasty showed that 3 of the 4 children had complete trachea rings, 2 had pulmonary artery sling, and 2 had multiple stenosis. Slide tracheoplasty was performed in the hospital on 3 children, and the midpoint of the stenosis segment was judged under bronchoscopy, and the length of the stenosis segment was measured, which assisted in the resection of the stenosis segment of the trachea. The pathogens were identified by lavage after the surgery. One child who developed scar traction 9 months after slide tracheoplasty in another hospital was improved by interventional treatment under bronchoscopy. Mucosal changes were found under bronchoscopy in 2 children 4 days after surgery, and the treatment plan was adjusted. One month after surgery, 2 children had granulation hyperplasia, which was improved by cryotherapy under bronchoscopy. One child abandoned treatment due to anastomotic necrosis and died. Three survivors were followed up for over 6 months with good prognosis, but all had tracheobronchial malacia. CONCLUSIONS Bronchoscopy can be used for the management of slide tracheoplasty in children with tracheal stenosis, which is helpful to postoperative rehabilitation and follow-up.
Child ; Humans ; Bronchoscopy ; Constriction, Pathologic ; Retrospective Studies ; Trachea/surgery* ; Tracheal Stenosis/surgery* ; Treatment Outcome

Objective: This single-subject case study was done to evaluate the presence and evaluate the risk factors for the development of Work-Related Musculoskeletal Disorders (WMSDs) among the staff performing bronchoscopy in the bronchoscopy suite. Methods: A single-subject case study to describe the ergonomic issues in bronchoscopy including identifying multiple factors that can potentially, either singly or in combination, affect physical work capacity. The study focused on the evaluation and control of occupational factors during bronchoscopy to improve awareness of ergonomic issues in bronchoscopy using the following data collection tools: 1) hierarchical task analysis, 2) activity sampling, 3) direct observation of the procedure (walk-around), 5) structured interview of the subject, and 5) utilization of checklists. Results: During the process of bronchoscopy, identified factors that can cause pain in the wrists, fingers, and shoulders include repetitive movement and awkward positions of the hands and wrists coming from the need to move the directional controls and position the bronchoscope. For the back, prolonged standing with awkward postures is a concern. For the neck, the need to look at the monitor which is situated at the side of the patient and frequent shifting of the eyes and head from the monitor to the patient can cause neck pain and stiffness. Aside from the above, other factors would include job stress from the workload, inadequate time for rest and recovery, and the possibility of an uncomfortable environment due to poor air quality. Chronic exposure and repeated injury followed by inflammation and repair lead to structural and biochemical changes in the tissues affected by Cumulative Trauma Disorders (CTDs) leading to the development of WMSDs. Conclusion Although CTDs do not account for work-related deaths, they do account for a significant amount of human suffering, loss of productivity, and economic burden on the compensation system. Thus, ergonomic concerns must be addressed early to prevent WMSDs/CTDs.
Bronchoscopy ; occupational health

Humans ; Multiple Pulmonary Nodules ; Lung ; Lung Neoplasms/surgery* ; Solitary Pulmonary Nodule/surgery* ; Bronchoscopy

Child ; Humans ; Bronchoscopy/methods* ; Biopsy/methods* ; Lung/pathology*

BACKGROUND: The incidence and mortality of lung cancer have always been at the forefront of malignant tumors. With the development of lung cancer detection techniques, more peripheral pulmonary lesions (PPLs) have been detected. The diagnostic accuracy of procedures for PPLs keeps controversial. This study aims to systematically evaluate the diagnostic value and the safety of electromagnetic navigation bronchoscopy (ENB) in the diagnosis of PPLs. METHODS: The relevant literatures in the diagnostic yield of PPLs by ENB were systematically retrieved from Wanfang Data Knowledge Service Platform, China National Knowledge Infrastructure, Embase, PubMed, Cochrane Library and Web of Science. The software of Stata 16.0, RevMan 5.4 and Meta-disc 1.4 were used to conduct the meta-analysis. RESULTS: A total of 54 literatures with 55 studies were included in our meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of ENB in the diagnosis of PPLs were 0.77 (95%CI: 0.73-0.81), 0.97 (95%CI: 0.93-0.99), 24.27 (95%CI: 10.21-57.67), 0.23 (95%CI: 0.19-0.28) and 104.19 (95%CI: 41.85-259.37), respectively. The area under curve (AUC) was 0.90 (95%CI: 0.87-0.92). Meta-regression and subgroup analyses indicated that the potential heterogeneity resulted from study type, additional localization techniques, sample size, lesion size and type of sedation. The use of additional localization techniques and general anesthesia have improved the diagnostic efficiency of ENB in PPLs. The incidence of adverse reactions and complications associated with ENB was very low. CONCLUSIONS ENB provides well diagnostic accuracy and safety.
Humans ; Bronchoscopy ; Lung Neoplasms ; Anesthesia ; China ; Electromagnetic Phenomena

Transbronchil biopsy has the characteristic of less trauma and quick recovery compared to percutaneous aspiration biopsy. In order to automate this procedure, it requires the development of a robotic surgical system that combines electromagnetic navigation and flexible endoscope. The robotic surgical system introduced herein consists of flexible endoscope, remote-control handle, electromagnetic navigation and dexterous manipulators. The robotic system supports lung bronchial model segmentation and reconstruction, automatic bronchial path planning, real-time navigation and visual biopsy. In the control of the endoscopic catheter, an elasticity compensation algorithm was proposed to improve the location accuracy of the catheter and operational efficiency. Clinical trials proved that the robotic system had high positioning accuracy, was intuitive to operate, and could improve the biopsy efficiency, shorten the learning time, reduce the burden of surgical operations, and lower radiation exposure and infection rate.
Catheters ; Robotic Surgical Procedures ; Endoscopy ; Bronchoscopy

Humans ; Child ; Lung Diseases, Interstitial/diagnosis* ; Lung/pathology* ; Biopsy/methods* ; Bronchoscopy/methods*