• Hiroyuki Kaneda, Ken-ichiro Minami, Takahito Nakano, Yohei Taniguchi, Tomohito Saito, Toshifumi Konobu, and Yukihito Saito.
• Division of Thoracic Surgery, Kansai Medical University Hirakata Hospital, Osaka, Japan. Electronic address: kanedah@hirakata.kmu.ac.jp.
• Respir Investig. 2015 Jan 1; 53 (1): 30-6.

BackgroundWe reviewed our clinical experience and examined the efficacy and long-term outcome of bronchial occlusion with endobronchial Watanabe spigots (EWSs).MethodsWe 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.ResultsOf 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.ConclusionsWe 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.Copyright © 2014 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

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