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Original Article
Efficacy of Foreign Body Removal using a Cryoprobe in Flexible Bronchoscopy
Go Eun Yeo, Sung-Jin Nam, Yu Jin Han, Eun Jeong Kim, Nam Kyu Kim, So Young Ock, Weon Hyoung Lee, Chul Ho Oak, Mann Hong Jung, Tae Won Jang
Kosin Medical Journal 2014;29(1):31-36.
DOI: https://doi.org/10.7180/kmj.2014.29.1.31
Published online: December 17, 2014
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Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: Chul Ho Oak, Department of Internal Medicine, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6104 FAX: +82-82-51-990-3049 E-mail: oaks70@daum.net
• Received: June 18, 2013   • Revised: August 27, 2013   • Accepted: October 16, 2013

Copyright © 2014 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • Objectives
    Endobronchial foreign body impaction is a medical emergency because of the air way obstruction. Therefore, immediate foreign body removal is crucial in such situations. Recently, there have been several reports about cryoprobe use as a tool for removal of foreign bodies. In this study, we determined the efficacy and complications of foreign body removal using a cryoprobe during flexible bronchoscopy.
  • Methods
    This is a retrospective review of 27 patients who visited Kosin University Gospel Hospital from August 2007 to August 2010 with respiratory symptoms due to a foreign body in the airway. There were 17 males and 10 females, aged from 7 to 78 years. The foreign bodies were more frequently located (55%) in the right bronchus. The cryoprobe was inserted through the forceps channel of the flexible bronchoscope under local anesthesia. The lesion was quickly frozen for 5 seconds at -80℃, and the bronchoscope was removed with the probe after crystal formation on the contacted area.
  • Results
    The success rate of removal of foreign bodies was 85% (23/27) using the cryoprobe. One case of broncholith did not undergo attempted removal because of the possibility of excessive hemorrhage by the tight bronchus impaction, and three cases (plastic, silicon, and implant) failed due to limited crystal formation. There were no severe hemorrhages, arrhythmias, or casualties during the procedure.
  • Conclusions
    The removal of foreign body using a cryoprobe during flexible bronchoscopy was shown to be safe and effective. The nature of the material should be attempted before removing a foreign body.
Fig. 1.
The system for cryoprobe removal, a) cryosurgical unit b) flexible cryoprobe and c)pedal of the cryosurgical unit.
kmj-29-31f1.jpg
Fig. 2.
a) Broncholith was removed by cryotherapy through flexible bronchoscopy. b) The length of a removed stone at the right middle bronchus was 1.3 cm. (Reference: A Case of Endobronchial Actinomycosis with Broncholith Removed by Cryotherapy through Flexible Bronchoscopy. Scheduled to be published in Kosin Medical Journal, December of 2013).
kmj-29-31f2.jpg
Fig. 3.
a) A fish bone was extracted from the bronchus. b) Size of the extracted fishbone compared with a human finger tip. c) An impacted artificial tooth crown was seen on bronchoscopy. d) The artificial tooth crown was successfully extracted.
kmj-29-31f3.jpg
Table 1.
Patient demographics and accompanying symptoms
Variable
Age/Mean age (years) 7~78/39  
Male/Female 17/10 63/37(%)
Symptoms Number of patient Percentage (%)
Coughing 27 100
Sputum 25 92
Dyspnea 17 63
Wheezing 10 37
Chest pain 10 37
Fever 10 37
Table 2.
Location of impacted foreign bodies
Bronchus location Number of cases Percentage (%)
Right main bronchus 15 55
Left main bronchus 5 19
Right middle bronchus 5 19
Left lingular bronchus 2 7
Table 3.
Types of foreign bodies
Type Number of foreign bodies
Broncholith 10
Peanut 5
Fishbone 4
Chicken bone 1
Tooth 2
Artificial tooth 2
Plastic 1
Implant 1
Silicon tube 1
Table 4.
Removal method and number of foreign bodies
Type Number of cases
Cryotherapy 23
Snare removal 1 (screw)
Forgarty catheter 2 (bead, silicon tube)
Surgical treatment 1 (broncholith)
(e.g., lobectomy)  
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