Abstract

Objectives: This study aims to evaluate the outcomes of Foley catheter extraction for esophageal coin removal in children and to determine the factors influencing procedural success, with particular focus on the role of sedation.

Patients and methods: Between January 2015 and December 2024, a total of 90 pediatric patients presenting with esophageal coin ingestion were retrospectively reviewed. Following the exclusion of patients who underwent primary endoscopic removal, the remaining 72 patients were evaluated in two groups based on the sedation approach: the sedated group (13 males, 9 females; mean age: 43.1 ± 26.6 months; range, 9 to 108 months) and the non-sedated group (31 males, 19 females; mean age: 48.4 ± 29.4 months; range, 9 to 144 months). Demographic characteristics, coin location, time from ingestion to presentation, extraction method, sedation use, and complications were recorded. Sedation (intravenous midazolam 0.1 mg/kg) was selectively administered when poor cooperation was anticipated. Failure after three attempts prompted endoscopic removal. Sedated and non-sedated groups were compared using chi-square and Fisher's exact tests.

Results: Among the patients who underwent Foley catheter extraction, 22 received sedation, and 50 were managed without sedation. Overall success was 77.8% (56/72). Success was higher in sedated patients (90.9%, 20/22) than in non-sedated patients (72.0%, 36/50), although this difference did not reach statistical significance (odds ratio: 3.89; p = 0.122). Complications were minimal and limited to nasopharyngeal migration (n = 2) and vomiting (n = 2); importantly, all complications occurred in the non-sedated group. No respiratory or sedation-related adverse events occurred. The mean post-procedure observation time was significantly longer in the sedated group (3.1 vs. 2.1 h).

Conclusion: Foley catheter extraction is a safe and effective method for esophageal coin removal in children. Non-sedated extraction was successful in the majority of cases, while sedation may be considered in selected patients where poor cooperation is anticipated.

Citation: İnanç İ, Yıldız S, Köprülü MS, Erdener Çeliktürk C, Avlan D. Foley catheter extraction for esophageal coin removal in children: The role of sedation. Turkish J Ped Surg 2026;40(2):81-86. doi: 10.62114/JTAPS.2026.204.

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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The authors declare that artificial intelligence (AI) tools were not used, or were used solely for language editing, and had no role in data analysis, interpretation, or the formulation of conclusions. All scientific content, data interpretation, and conclusions are the sole responsibility of the authors. The authors further confirm that AI tools were not used to generate, fabricate, or ‘hallucinate’ references, and that all references have been carefully verified for accuracy.

İ.İ., D.A.: Concept; İ.İ., S.Y., D.A.: Design; Supervision, critical review: D.A.; İ.İ., S.Y., M.S.K., C.E.C.: Data collection and/or processing; İ.İ., S.Y.: Analysis and/or interpretation; M.S.K., C.E.C.: Literature review; İ.İ.: Writing the article. All authors reviewed the results and approved the final version of the manuscript.

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

The authors received no financial support for the research and/or authorship of this article.