2018 Volume 32 Issue 7 Pages 830-836
Thoracoscopic debridement of the cavity and closure of the fistula to prevent empyema are minimally invasive and useful. However, if the fistula cannot be controlled after surgery, open-window thoracostomy is often required. We used an Endobronchial Watanabe Spigot (EWS) for thoracoscopic surgery in 3 cases of empyema with fistula at the same time and tried to control the fistula. In 2 cases, the postoperative fistula was controlled, and they were discharged on the 17th and 28th postoperative days.
One patient had recurrence of postoperative empyema and underwent open-window thoracostomy, but since the fistula was controlled by EWS, the thoracostomy could be closed one month later. The use of EWS in thoracoscopic surgery prevents transition to open-window thoracostomy, and even if a shift to thoracostomy is necessary, the fistula is controlled and it is possible to close the thoracostomy early. Thoracoscopic surgery with EWS is considered to be an effective treatment against empyema with fistula.
