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Retained Object Risk for Kids Is Highest in GYN Procedures

Analysis shows more foreign bodies left in pediatric patients undergoing pelvic surgery.

Published: November 18, 2010

The risk of leaving a foreign body in a pediatric surgical patient is greater during gynecological procedures than it is with other types of surgery, according to a recent analysis of adverse events in pediatric patients.

Overall, the risk of leaving a sponge, instrument or other foreign body in a child undergoing surgery is very small — only about 0.02%, according to the analysis of 1.9 million children hospitalized between 1988 and 2005. Compared with ENT, heart and chest, orthopedic, spine and other types of procedures, GYN procedures were associated with the highest risk of retained objects. The highest percentage of retained object errors in the study group occurred during GI surgeries, but because of their frequency, the rate of retained objects was not as high for GI as it was for GYN procedures.

Retained foreign objects in pediatric patients were associated with longer hospital stays and increased medical costs, but not an increased risk of death, according to researchers at Johns Hopkins Children's Center in Baltimore, Md.

Study author Fizan Abdullah, MD, says the higher risk associated with pediatric gynecology was not due to greater carelessness among gynecologists. "It's because of the anatomic considerations in that part of the body when you are operating," he explains, specifically recesses in the pelvis where sponges can be difficult to detect.

The researchers say their findings, published in the Archives of Surgery, highlight the need for more research into which specific procedures pose the greatest risk of retained foreign bodies, "because awareness of a higher risk could prompt the need for greater attention to prevent the occurrence of an adverse event."

Irene Tsikitas

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