Effectiveness of a cap-assisted device in the endoscopic removal of food bolus obstruction from the esophagus

The use of a transparent cap has been found to be effective for retrieval of an esophageal foreign body. However, data on the use of a cap in food bolus obstruction (FBO) are limited. This study aims to assess the effectiveness of a cap-assisted technique compared with conventional techniques in removal of FBO. All patients who underwent an endoscopy for boneless FBO between 2011 and 2016 were prospectively recruited. The measured outcomes were procedure time, success rate of food bolus (FB) extraction, rate of en bloc removal, procedure-related adverse events, and length of hospital stay (LOS) between the 2 groups. Of the 315 patients who had an endoscopy for FBO, 48 (15.2%) had spontaneous passage of FB and 267 (84.8%) had impacted FB. Sixty-eight (25%) patients had the “push” maneuver, and 199 (75%) patients had the “pull” maneuver to remove FB. Of those who had the “pull” maneuver, a cap was used for 93 and conventional device(s) for 106. The use of a cap was associated with a shorter procedural time (34.3 ± 8.0 minutes versus 43.3 ± 22.6 minutes, P = .003), a higher rate of en bloc removal (87.3% versus 22.8%, P < .001), a lower rate of adverse events (0/93 versus 7/106, P = .01), and a shorter LOS (1.0 ± 0.6 days versus 1.6 ± 1.4 days, P = .0017). The cap-assisted technique has been found to be effective and safe in removal of esophageal FBO. This technique was associated with a shorter procedural time and a reduced LOS compared with conventional techniques. However, these findings require further validation in a randomized control study.