A simple method of bronchial occlusion with silicone spigots (Endobronchial Watanabe Spigot; EWS) using a curette

Autor: Sayako Morikawa, Takuya Okamura, Tomoyuki Minezawa, Yasuhiro Goto, Masamichi Hayashi, Teppei Yamaguchi, Sumito Isogai, Yuki Mieno, Naoki Yamamoto, Sakurako Uozu, Toru Nakanishi, Mitsushi Okazawa, Kazuyoshi Imaizumi
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Zdroj: Therapeutic Advances in Respiratory Disease, Vol 10 (2016)
Druh dokumentu: article
ISSN: 1753-4658
1753-4666
17534658
DOI: 10.1177/1753465816664862
Popis: Background: Bronchial occlusion with an Endobronchial Watanabe Spigot (EWS) has been shown to be useful in managing prolonged bronchopleural fistulas and intractable hemoptysis. EWS bronchial occlusion using a curette is less technically demanding. This retrospective study evaluated the clinical utility and simplicity of this method. Methods: A total of 18 consecutive patients (15 men, 3 women, aged 47–85 years) who underwent bronchial occlusion using an EWS from April 2012 to August 2014 were evaluated. The method involves sticking the tip of a curette into an EWS to the first joint, allowing it to be turned in any direction or at any angle. The time required to occlude the target bronchus was measured on routinely recorded digital videos. Other parameters evaluated included success rates, complications, and clinical outcomes. Results: Of the 18 patients, 11 underwent bronchial occlusion for intractable pneumothorax, 5 for postoperative bronchopleural fistula, two for intractable empyema, and one for hemoptysis. Each patient required 1–7 EWSs (median 4). Target bronchi included the right upper ( n = 8), left upper ( n = 5), right lower ( n = 2), left lower ( n = 2), and right middle ( n = 1) bronchi. The success rate of EWS insertion into the target bronchus was 100%. Time per EWS occlusion ranged from 65–528 sec (median 158.5 sec). Of the 62 insertions, 36 (58.1%) were completed within 3 min, and 58 (93.5%) within 5 min. Successful outcomes were observed in 15 (83.3%) of the 18 patients. Conclusions: EWS bronchial occlusion using a curette is a simple method for managing intractable bronchopleural fistulas in daily clinical settings.
Databáze: Directory of Open Access Journals
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