Occlusion with Endobronchial Watanabe Spigot for the management of critical patients with massive hemoptysis

Abstract

Objective: Mortality rates for massive hemoptysis range from 7.1% to 18.2%. With the endobronchial Watanabe Spigot (EWS) in the control of massive hemoptysis, lober occlusion may be preferred in the first stage of emergency treatment. In this study, we evaluated the efficacy and complications of massive hemoptysis control by discussing the results of EWS using 22 consecutive massive hemoptysis case. Methods: This study included patients admitted to the intensive care unit due to massive hemoptysis and underwent EWS with rigid bronchoscopy under general anesthesia. Complications during and after the procedure were recorded, and the efficacy of the method was evaluated. Results: Mean age was 56.5±11.7 years. A patient who suffered massive bleeding due to failed intervention went to lobectomy. Mean duration of hospitalization was 11.7 days. In three cases with hemoptysis control, migration of EWS was observed on postoperative 4-11. days. One patient was exposed the spigot on day 50 and the other patient on day 8. Lobectomy was performed in a patient with a right upper apical segment. Age, gender distribution, length of stay, spigot number, survival time, smoking status, diagnosis and treatment success did not differ significantly in patients with and without complications (p ˃ 0.05). Conclusion: Lobular occlusion with EWS in massive hemoptysis control may be preferred in the first stage of emergency treatment, particularly in patients with tuberculosis or surgically inoperable massive hemorrhage. It is accepted as a safe and effective practice in order to avoid the risks of major surgery.