J. Tashiro1, E. A. Perez1, H. L. Neville1, A. R. Hogan1, J. E. Sola1 1University Of Miami,Division Of Pediatric Surgery, DeWitt Daughtry Family Department Of Surgery,Miami, FL, USA
Introduction: Retained foreign bodies (RFB) are a preventable, yet significant source of morbidity and resource utilization in all surgical subspecialties. In 2008, the World Health Organization introduced “Guidelines for Safe Surgery” (WHO/GSS). We sought to examine rates of RFB in children undergoing abdominal surgical procedures.
Methods: The Kids’ Inpatient Database was used to identify cases of RFB using ICD-9-CM codes in children <18 years of age between 1997 and 2009. Cases were further narrowed to abdominal procedures using 549.2 (removal of foreign body from peritoneum). Analyses were performed using standard statistical methods. Cases were weighted to project nationally representative results.
Results: Overall, 107 cases of RFB were identified. Mean age of the cohort was 9.94±6.35 years of age. Average length of stay and total charges were 11.0±11.4 days and 68,502.77±81,365.61 USD, respectively. Rates of RFB have decreased steadily between 2003-2009 (0.09-0.06 per 1,000 abdominal procedures). A comparison of pre-WHO/GSS vs. post-WHO/GSS did not demonstrate a difference in rate of RFB. Fundoplications had the highest rates of RFB (5.97 per 1,000 procedures), followed by gastric procedures (1.31), laparotomy (1.23), bile duct procedures (0.81), lysis of adhesions (0.80), and abdominal wall repair (0.42).
Conclusion: RFB rates have decreased steadily since 2003-2009; however, RFB rates do not demonstrate a difference after WHO/GSS implementation. Higher rates of RFB are associated with fundoplications and other gastric procedures. RFB continue to be an ongoing issue in pediatric surgery that requires further investigation.
