Bronchial Occlusion with EWS (Endobronchial Watanabe Spigot) in Secondary Intractable Pneumothorax, Pulmonary Fistula, and Pulmonary Hemorrhage etc.

We made the first report on bronchial Occlusion with silicone in 1991, and developed EWS, a silicone made bronchial filler, in 2000. This method provides a surer bronchial blockade than conventional methods. As a rule, bronchial occlusion with EWS is performed with fiberoptic bronchoscope under local anesthesia. In this paper, we analyze outcome data reports from 79 institutes in Japan, and evaluate the efficacy and safety of this method. Reported cases of EWS are consisted of 115 cases of secondary intractable pneumothorax, 39 cases of pyothorax with bronchial fistula, 20 cases of prolonged air leakage after pulmonary surgery, 6 cases of bronchial fistula with other organs, and 1 case of pulmonary hemorrhage. With this procedure, air leakage (or hemorrhage) was stopped or reduced in 131 cases (74.1%). As a complication related to this procedure, 7 cases of respiratory infection were observed, but they improved by administration of antibiotics. We developed EWS, a silicone made bronchial filler. Bronchial occlusion with EWS is thought to be useful in fistula management and pulmonary hemorrhage etc.