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



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.



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.



EWS bronchial occlusion using a curette is a simple method for managing intractable bronchopleural fistulas in daily clinical settings.
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Sayako
S
Morikawa
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Takuya
T
Okamura
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Tomoyuki
T
Minezawa
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Yasuhiro
Y
Goto
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Masamichi
M
Hayashi
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Teppei
T
Yamaguchi
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Sumito
S
Isogai
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Yuki
Y
Mieno
Laboratory of Molecular Biology and Histochemistry, Fujita Health University, Toyoake, Aichi, Japan.
Naoki
N
Yamamoto
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Sakurako
S
Uozu
Department of Respiratory Medicine, Fujita Health University, Toyoake, Aichi, Japan.
Toru
T
Nakanishi
Department of Respiratory Medicine and Clinical Allergy, Daiyukai General Hospital, Ichinomiya, Aichi, Japan.
Mitsushi
M
Okazawa
Department of Respiratory Medicine, Fujita Health University, 1-98, Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan jeanluc@fujita-hu.ac.jp.
Kazuyoshi
K
Imaizumi
D000368:Aged; D000369:Aged, 80 and over; D001983:Bronchial Fistula / Q000628:therapy*; D004653:Empyema / Q000628:therapy; D005260:Female; D006469:Hemoptysis / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010995:Pleural Diseases / Q000628:therapy*; D011030:Pneumothorax / Q000628:therapy*; D011183:Postoperative Complications; D012826:Silicone Elastomers; D060205:Therapeutic Occlusion / Q000295:instrumentation / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
D012826:Silicone Elastomers
Endobronchial Watanabe Spigot; bronchial occlusion; bronchopleural fistula; bronchoscopy; curette