title: Efficacy and long-term clinical outcome of bronchial occlusion with endobronchial Watanabe spigots for persistent air leaks.
abstract: BACKGROUND
  We reviewed our clinical experience and examined the efficacy and long-term outcome of bronchial occlusion with endobronchial Watanabe spigots (EWSs).
  
  
  METHODS
  We retrospectively reviewed the clinical charts of patients who had undergone endoscopic bronchial occlusion with EWSs between July 2002 and July 2004. The affected bronchi were identified by chest computed tomography, pleurography, and balloon occlusion test.
  
  
  RESULTS
  Of the 21 patients, 18 had underlying pulmonary complications, including chronic obstructive lung disease (n=14), cancer (n=4), pneumoconiosis (n=3), and pneumonia (n=1). Six (29%) achieved complete resolution and 12 (57%) experienced a reduction in air leaks after the first EWS insertion. Of the 12 patients with reduced air leaks, 10 subsequently underwent chemical pleurodesis and 5 (24%) achieved complete resolution after the procedure. A second EWS insertion procedure was performed for 8 patients: 2 achieved complete resolution and 5 achieved a further reduction in air leaks with complete resolution after chemical pleurodesis. Eighteen of the 21 patients were followed up at an outpatient clinic after discharge: 13 for more than 12 months and 4 for more than 84 months. During the follow-up period, most patients did not show any obvious pulmonary complications.
  
  
  CONCLUSIONS
  We showed that bronchial occlusion with EWSs was effective in stopping or reducing air leaks and that 86% of our patients finally achieved complete resolution, some when the occlusion was combined with chemical pleurodesis. The rate of complications was acceptable, even after long-term placement.
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: kanedah@hirakata.kmu.ac.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kaneda
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: minami.ken@nifty.com.
authors.forename: Ken-ichiro
authors.initials: K
authors.lastname: Minami
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: nakantak@hirakata.kmu.ac.jp.
authors.forename: Takahito
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: taniguyo@hirakata.kmu.ac.jp.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Taniguchi
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: saitotom@hirakata.kmu.ac.jp.
authors.forename: Tomohito
authors.initials: T
authors.lastname: Saito
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: tkonobu@hirakata.kmu.ac.jp.
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Konobu
authors.affiliation: Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: saitoy@hirakata.kmu.ac.jp.
authors.forename: Yukihito
authors.initials: Y
authors.lastname: Saito
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001999:Bronchoscopy / Q000379:methods*; D004653:Empyema / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018700:Pleurodesis / Q000379:methods; D011030:Pneumothorax / Q000628:therapy*; D012189:Retrospective Studies; D060205:Therapeutic Occlusion / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Bronchoscopic surgery; Empyema; Pneumothorax; Postoperative complication