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Da-Quan Wu,1,&ast; Shu-Yang Chen,1,&ast; Ke-Guang Chen,1 Tan Wang,1 Guang-Yao Li,2 Xin-Sheng Huang1 1Otolaryngology Head and Neck Surgery, Zhongshan Hospital, Shanghai, 200032, People’s Republic of China; 2Department of Otolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Xin-Sheng Huang; Guang-Yao Li, Email hxs_zs@163.com; 22111260027@m.fudan.edu.cnBackground: Sharp esophageal foreign body (SEFB) impaction can cause varying degrees of damage to the esophagus. There are few studies analyzing the postoperative fasting time in SEFB patients.Methods: We retrospectively collected 835 SEFB patients. According to the fasting time after the endoscopic removal (ER) of SEFBs, the patients were divided into two groups: short fasting time (SFT, fasted ≤ 24 h) and long fasting time (LFT, fasted > 24 h).Results: There were 216 and 619 patients in the SFT and LFT group, respectively. The average age of the SFT group (52.97 years) was younger than that of the LFT group (55.96 years) (p = 0.025). The LFT group had lower proportion of duration of impaction (DOI) within 12 hours (14.2% vs 22.2%, p = 0.006) and erosion rates (89.0% vs 94.0%, p = 0.034) as well as higher proportion of esophageal perforation (19.5 vs 6.5%, p = 0.010) and patients who got intravenous anesthesia (63.78% vs 31.9%, p = 0.000) than the SFT group. The longest diameter of the foreign body (Lmax) in the LFT group (2.60 ± 1.01 cm) was greater than that in the SFT group (2.41 ± 0.83 cm; p = 0.01). Multivariate regression analysis found that age (OR = 1.726[1.208– 2.465], p = 0.003), DOI (OR = 1.793[1.175– 2.737], p = 0.007), Lmax (OR = 1.477[1.033– 2.111], p = 0.032), perforation (OR = 3.698[2.038– 6.710]; p < 0.01) and intravenous anesthesia (OR = 3.734[2.642– 5.278]; p < 0.01) were the independent factors that prolonged fasting time in patients with SEFBs, wh