Device choice and experience level in endoscopic foreign object retrieval: An in vivo study

作者：Douglas O. Faigel, Brian R. Stotland, Michael L. Kochman, Timothy C. Hoops, Thomas A. Judge, Joyann A. Kroser, James D. Lewis, William B. Long, David C. Metz, Christopher O'Brien, Deborah B. Smith, Gregory G. Ginsberg · 发表于：Gastrointestinal Endoscopy · 年份：1997 · DOI：10.1016/s0016-5107(97)70179-2 · 被引用次数：99 · 研究领域：Foreign Body Medical Cases、Medical Device Sterilization and Disinfection、Airway Management and Intubation Techniques

BACKGROUND: Successful foreign object retrieval may depend on device choice and the experience level of the endoscopist, although these factors have not been systematically evaluated. METHODS: In anesthetized pigs, the ability to retrieve foreign objects (metal tack, button disc battery, wooden toothpick) placed endoscopically into the stomach was assessed. Seven university medical center gastroenterology attending physicians (5 clinical and 2 basic science research [BSR]), and 4 fellows-in-training participated. The devices used were the Roth retrieval net, rat tooth forceps, Dormia basket, polypectomy snare, and radial jaw forceps. The time to retrieve each object into an esophageal overtube within a 5 minute maximum was measured. RESULTS: Only the Roth net and Dormia basket were successful in retrieving the button disc battery, although the Roth net was superior (100% vs 27%, Fisher p < 0.025). All devices were equally successful at retrieving the tack (82% to 100%, p = NS). The snare was significantly faster than the Roth net (p < 0.05). For the tack, there was significantly fewer difficulties encountered with the snare than the Roth net (Fisher p < 0.03). The Roth net was incapable of retrieving the toothpick; the other devices were equally successful (91% to 100%). The clinical attendings had a significantly higher success rate (95%) than the fellows (82%, chi squared p < 0.05) or combined fellows/BSR attendings (80%, p < 0.02), and were significantly faster than the fe...