title: Endobronchial Watanabe Spigot Placement for a Secondary Pneumothorax.
abstract: Although bevacizumab has several adverse effects, pneumothorax is rare. This is the first case of initial treatment using an Endobronchial Watanabe Spigot (EWS) for pneumothorax after bevacizumab-containing chemotherapy. A 56-year-old woman with recurrent breast cancer was treated with bevacizumab. Pneumothorax occurred 6 days after the last administration of bevacizumab. The pneumothorax failed to resolve after the chest tube drainage. This was because the bronchopleural fistula formed at the site of the subpleural metastatic lesion. Patient was in need of a surgical repair of the bronchopleural fistula, which could not be carried out due to the recent bevacizumab administration. After the insertion of the EWS, the air leak stopped immediately. A lobectomy was successfully performed for the recurrent pneumothorax and for the resection of the metastatic lung lesion; at a most appropriate duration since the chemotherapy. EWS is useful as the initial palliation of pneumothorax after the treatment with medication causing delayed wound healing.
authors.affiliation: *Department of Thoracic Surgery, Tenri Hospital, Nara †Department of Thoracic Surgery and Respiratory Medicine, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ueda
authors.forename: Cheng-Long
authors.initials: CL
authors.lastname: Huang
authors.forename: Ryo
authors.initials: R
authors.lastname: Itotani
authors.forename: Motonari
authors.initials: M
authors.lastname: Fukui
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D000068258:Bevacizumab / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy; D001983:Bronchial Fistula / Q000209:etiology; D001999:Bronchoscopy / Q000295:instrumentation / Q000379:methods; D015505:Chest Tubes; D004322:Drainage / Q000379:methods; D005260:Female; D006801:Humans; D008875:Middle Aged; D011030:Pneumothorax / Q000139:chemically induced* / Q000601:surgery*; D012008:Recurrence
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab