Preliminary Study About A New Endoscopic Balloon Dilation In The Foreign Body Removed From Upper Gastrointestinal Tract

Objective:Foreign bodies in upper gastrointestinal tract are common clinical emergency.At present,the treatment includes endoscopic removal and surgical operation.The later is traumatic,so former is the most routine methods.However,for large and irregular foreign bodies,especially sharp one embedded in the thoracic esophagus.It can developed mucosal injury,bleeding,perforation and infection during removal,which may endanger life.To invent a new type of endoscopic dilatation balloon.To observe the feasibility,safety and evaluate the therapeutic effect of new endoscopic balloon dilation for foreign bodies removed in upper gastrointestinal tract,so as to provide a new method for the removal of foreign bodies in patients.Methods:From June 2018 to February 2019,we collected 10 cases who admitted to the department of gastroenterology,emergency,otolaryngology in the First Affiliated Hospital of Soochow University,including five cases of cervical esophagus,three cases of thoracic and two cases of gastric phytobezoar.Blood coagulation,blood routine,ECG,etc.were carried to eliminate contraindications.Patients gave their informed consent for biomedical research were designed by Medical Ethics Committee of the First Affiliated Hospital of Suzhou University.After CT or gastroscopy confirming the location,the endoscopic balloon dilation was fixed at the front of the gastroscope.The endoscope entered the esophagus or gastric cavity with after testing the size of air injection and balloon dilatation in vitro.For foreign bodies in the esophagus,the esophageal lumen is dilated so as to take out it;For foreign bodies in the stomach,the esophageal lumen is dilated to facilitate the passage of foreign bodies through the narrow segment.The bleeding and pain of patients were closely observed.The success rate of operation,the time of take out,visual field clarity,mucosal injury and complications were observed.Results:Among the ten patients,one case had intestinal obstruction was removed surgically.nine cases successfully completed with it.The success rate was 100%(9/9),and the vital signs of the patients were stable during the removal process.Five cases of cervical esophagus were followed up after removal.Three cases of thoracic esophagus,one near aortic arch(about 3.5mm),one near left subclavian artery(about 5.0mm),last one near the aortic arch(about 1.9mm).The patients were discharged from hospital after routine fasting,acid suppression and anti-infection treatment.Two cases of gastric phytobezoar,one case of gastric cancer underwent Billroth I operation.After conservative treatment for one week,the stones were successfully removed through basket(about 3.0*4.0cm)and no discomfort during the feeding of semifluids.One case with gastric ulcer after Billroth I operation.After conservative treatment,the abdominal pain were further aggravated.However,it is not obvious residual stomach stones were found.Abdominal CT examination showed that the proximal small intestine was dilated,and then transferred to surgery to remove the stomach stone(about 3.0 x 7.0 cm).After routine anti-infection,acid suppression and fluid replacement symptomatic treatment,the patient recovered one week later.All patients were followed up for 1 month without obvious discomfort.Conclusion:The endoscopic balloon dilation is a safe,feasible and effective method for successful removal of foreign bodies in upper gastrointestinal tract.Its operation is simple,practical,less complications,and has a good clinical popularization value.