Non-foreign body-associated risk factors for complications associated with esophageal foreign-body removal and timing of endoscopic treatment: a single-center retrospective study

BackgroundComplications from prolonged esophageal foreign body impaction are well-documented, yet the significance of non-foreign body factors has not been thoroughly explored. This study aims to investigate non-foreign body risk factors for complications during esophageal foreign-body removal and to evaluate the impact of treatment timing.StudyWe conducted a retrospective evaluation of patients diagnosed with esophageal foreign bodies requiring gastroscopic removal in our hospital between January 2019 and December 2020. Non-foreign body factors, such as whether endoscopic treatment was on the day of the visit, visiting time, complaint time (from ingestion to presentation), anesthesia method, and holidays, were considered.ResultsIn total, 831 patients were included. The success rate of endoscopic treatment was 97.8%. The overall probabilities of mucosal injury, bleeding, and perforation were 90.3%, 53.3%, and 6.9%, respectively. The treatment was performed on the day of the patient's visit for 70.4% patients, under sedation anesthesia for 50.7% patients, and in the early night for 44.6% patients. Treatment on the day of the visit did not affect the success rate. Same-day treatment was a protective factor for mucosal injury and perforation on univariate logistic regression analysis, but did not independently influence mucosal injury, bleeding, or perforation on multivariate analysis. Visiting time, complaint time, and holidays affected the complication rate. During the COVID-19 period in China, visiting time and anesthesia method were found to be independent predictors of same-day treatment.ConclusionsComplaint time, visiting time and same-day treatment are significant and practical factors influencing the complications of endoscopic foreign-body removal. Certain patients, notably night-time visitors, might benefit from delaying treatment until the following day to utilize sedative anesthesia to minimize risks.