Difficult removal after bronchial filling of an endobronchial Watanabe spigot with N‐butyl‐2‐cyanoacrylate for intractable pneumothorax: A case report. Issue 4 (21st March 2023)

• Record Type: Journal Article
• Authors: Nakamura, Tomoaki; Ro, Shosei; Morita, Chie; Kanomata, Naoki; Kitamura, Atsushi
• Is Part Of: Respirology case reports. Volume 11:Issue 4(2023)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2023-03-21
• Subjects: endobronchial Watanabe spigot -- foreign body granuloma -- N‐butyl‐2‐cyanoacrylate; Respiratory organs -- Diseases -- Periodicals; 616.2005
• DOI: 10.1002/rcr2.1126
• Languages: English
• ISSNs: 2051-3380

Abstract

Abstract: A 52‐year‐old man developed a right pneumothorax during treatment for COVID‐19. In a previous case report concerning this patient, his recovery was achieved through implanting four endobronchial Watanabe spigots (EWS) in the right B1 and B3 in two phases and spraying N‐butyl‐2‐cyanoacrylate (NBCA). One year later, EWS removal was planned. He was intubated under bronchoscopic guidance, and the right upper lobe was observed. The right B1 and B3 inlets were found to be covered with granuloma. Despite the presence of a nylon thread for easy retrieval and partial debridement of the granulation, removal of the implanted EWS in the right B1 and B3 using grasping forceps, basket forceps, and two types of balloons under fluoroscopic guidance was challenging. NBCA spraying is a possible cause of foreign body granuloma formation. Therefore, careful consideration of the indications for the combined EWS‐NBCA procedure is necessary. Abstract : This case report, involves a 52‐year‐old man who had previously developed a right pneumothorax during treatment for COVID‐19 and who we successfully treated through implanting four endobronchial Watanabe spigots (EWS) in the right B1 and B3 in two phases and spraying N‐butyl‐2‐cyanoacrylate (NBCA), we report on the surgical and technical challenges we faced 12 months later, when the decision was made to remove the EWS. Therefore, careful consideration of the indications for this procedure is necessary.