To retrospectively analyze the occurrence of complications in endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults and explore its risk factors.

A retrospective analysis was conducted on the data of adult patients who underwent endoscopic removal of sharp foreign bodies in the upper digestive tract at Pinggu District Hospital of Beijing from March 2021 to March 2025. Among them, 29 patients had complications (8 cases of perforation, 9 cases of bleeding, 7 cases of abscess, 5 cases of ulcer), and 188 patients had no complications. The age, gender, underlying diseases, size and shape of foreign bodies, location, retention time, endoscopy physician experience, selection of auxiliary instruments, preoperative mucosal injury, operation time, and antibiotic use of the two groups of patients were compared. Logistic multivariate regression analysis and receiver operating characteristic (ROC) curve were used to analyze the predictive value of the above factors for the occurrence of complications during endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract of adults.

There were statistically significant differences between the two groups in terms of age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury (P<0.05). Multivariate Logistic regression analysis showed that age >48 years old, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus were all independent risk factors affecting postoperative complications of sharp foreign bodies in the upper digestive tract of adults (P<0.05). ROC curve analysis showed that the combined AUC of indicators such as age >48 years, combined hypertension, foreign body size >22 mm, foreign body shape of needle/fish bone, retention time >16 hours, preoperative mucosal injury, and foreign body location in the upper segment of the esophagus for predicting postoperative complications of sharp foreign bodies in the upper gastrointestinal tract of adults was 0.872. Its sensitivity and specificity were 85.10% and 83.61% respectively.

Complications in adult patients undergoing endoscopic removal of sharp foreign bodies in the upper gastrointestinal tract are closely related to age, combined hypertension, foreign body size, foreign body shape, foreign body location, retention time, and preoperative mucosal injury, combined monitoring of the above factors can provide a reliable reference for the prevention and intervention of complications.