Clinical Evaluation of Endoscopic Bronchial Occlusion with an Endobronchial Watanabe Spigot for the Management of Intractable Pneumothorax, Pyothorax with Bronchial Fistula, and Postoperative Air Leakage
| Autor: | Gen-ichi Tanaka, Atsushi Yamanaka, Kiichiro Beppu, Daisuke Himeji, Ritsuya Shiiba, Chikara Fukuyama |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment intractable pneumothorax postoperative air leakage 030204 cardiovascular system & hematology Aspergillosis endobronchial Watanabe spigot 03 medical and health sciences Postoperative Complications 0302 clinical medicine Bronchoscopy Internal Medicine Humans Medicine Empyema Pleural Aged Retrospective Studies Aged 80 and over business.industry Pulmonary Fistula Pneumothorax Retrospective cohort study General Medicine Bronchial occlusion Middle Aged medicine.disease Bronchial Fistula pyothorax with bronchial fistula respiratory tract diseases Surgery Chest tube Chest Tubes Drainage Female Original Article 030211 gastroenterology & hepatology business Clinical evaluation |
| Zdroj: | Internal Medicine |
| ISSN: | 1349-7235 0918-2918 |
| DOI: | 10.2169/internalmedicine.3900-19 |
| Popis: | Objective The present study aimed to evaluate the clinical effectiveness of endoscopic bronchial occlusion (EBO) with endobronchial Watanabe spigots (EWSs) for the management of prolonged pulmonary air leaks, such as intractable pneumothorax, pyothorax with bronchial fistula, and postoperative air leakage. Methods This was a retrospective study. Between April 2005 and March 2018, we recruited 21 patients with intractable pneumothorax (10 cases), pyothorax with bronchial fistula (7 cases), and postsurgical pulmonary fistula (4 cases) in whom appropriate drainage for 2 weeks had been unsuccessful and who were unsuitable for surgery. An EWS was inserted using a flexible bronchoscope via an endotracheal or a tracheostomy tube. Results The mean number of sessions with EWS procedures was 1.94, and the mean number of inserted EWS per patient was 6.5. In addition to EWS procedures, pleural washing and pleural adhesion therapy were performed in all cases with pyothorax, whereas pleural adhesion therapy was performed in three patients with pneumothorax. The successful treatment rate was 85.7%. Reduction of air leakage was observed in 19/21 patients. The mean duration of reduction of air leaks was 4.1 days (median, 1; range, 0-24 days) following EWS procedures. The mean duration from tube insertion to chest tube removal was 43.4 days (median, 29; range, 16-105 days). Complications included spigot migration and infection (aspergillosis); no complications caused significant mortality. Conclusion Performing EBO using an EWS appears to be a reasonable option for the management of intractable pneumothorax, pyothorax with pulmonary fistula, and postoperative air leakage. |
| Databáze: | OpenAIRE |
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