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Observational Study
. 2023 Aug 30;53(9):829-836.
doi: 10.1093/jjco/hyad060.

Utility of the endobronchial Watanabe spigot for intractable cancer-related pneumothorax: a retrospective observational study

Masahiro Adachi  1   2   3 , Yuji Matsumoto  1   4 , Hideaki Furuse  1 , Keigo Uchimura  1 , Tatsuya Imabayashi  1 , Masaya Yotsukura  2 , Yukihiro Yoshida  2 , Kazuo Nakagawa  2 , Hiroshi Igaki  3   5 , Shun-Ichi Watanabe  2 , Takaaki Tsuchida  1
Affiliations
Observational Study

Utility of the endobronchial Watanabe spigot for intractable cancer-related pneumothorax: a retrospective observational study

Masahiro Adachi et al. Jpn J Clin Oncol. .

Abstract

Background: The use of endobronchial Watanabe spigots for intractable secondary pneumothorax in patients with cancer has not been adequate. This study aimed to investigate the use of endobronchial Watanabe spigots for intractable pneumothorax in patients with malignant tumors.

Methods: Consecutive patients with malignant tumors who underwent occlusion with an endobronchial Watanabe spigot for intractable pneumothorax associated with perioperative treatment or drug therapy at our institution between January 2014 and February 2022 were reviewed.

Results: Of the 32 cases in which an endobronchial Watanabe spigot was used, six were excluded; we thus evaluated 26 cases in which the chest tube was removed. Chest tubes were removed in 19 cases (73.1%) and could not be removed and required surgical treatment under general anesthesia in seven patients (26.9%), of which four (14.8%) underwent open-window thoracostomy. Half of the patients were treated with both an endobronchial Watanabe spigot and pleurodesis. Although thin-slice chest computed tomography revealed a fistula in 15 patients, the chest tube was removed in 11 (57.9%) patients. A significant difference was only observed in patients with a history of heavy smoking.

Conclusions: The chest tube removal rate was comparable to those reported in previous studies. An endobronchial Watanabe spigot may be a useful treatment option for intractable cancer-related pneumothorax.

Keywords: bronchoscopy; neoplasms; pneumothorax; pulmonology.

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Conflict of interest statement

The authors declare no conflict of interest associated with this manuscript.

Figures

Figure 1
Figure 1
How to use an endobronchial Watanabe spigot (EWS). (a) The EWS was cut in two directions parallel to the long axis. (b) A hole was made in the EWS with an 18-G needle, and the tip of the curette was inserted.
Figure 2
Figure 2
Patient flow chart for the endobronchial Watanabe spigot procedure.
Figure 3
Figure 3
Successful treatment using an endobronchial Watanabe spigot for postoperative prolonged air leak. A fistula is indicated by the white arrow.
See this image and copyright information in PMC

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