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3. Multimodal treatment for acute empyema based on the patient’s condition, including patients who are bedridden: A single center retrospective study

Author

Nishida Tomoki, Igarashi Yuto, Suno Yuma, Murata Takaaki, Miyake Katsunori, Isogai Naoko, Shimoyama Rai, Kawachi Jun, Kashiwagi Hiroyuki, Tsukiyama Toshitaka, and Fukai Ryuta

Subjects
Diseases of the respiratory system, RC705-779
Abstract

Background The incidence of acute empyema has increased in various countries; some elderly patients with acute empyema have contraindications for surgery under general anesthesia. Therefore, suitable management based on a patient's clinical condition is required. Methods We evaluated the different surgical and nonsurgical therapeutic approaches available for patients with acute empyema. This was a retrospective study of 57 patients with acute empyema who received treatment in our department between May 2015 and February 2019. For patients who did not initially improve with drainage or drainage combined with fibrinolytic therapy, surgery, or additional percutaneous drainage was performed based on their general condition. We compared several clinical factors pertaining to the patients who underwent surgical versus nonsurgical treatment. Results Our study showed that the patients with a performance status of 0--2 and an American Society of Anesthesiologists physical status classification of class II or lower underwent surgery safely without major operative complications. The combination of repeated drainage of the pleural cavity and fibrinolytic therapy appeared to be a reasonable nonsurgical management option for patients in poor overall condition. Conclusion For an aging population, we think that the combination of repeated pleural cavity drainage procedures and fibrinolytic therapy is a reasonable nonsurgical strategy for the management of patients with acute empyema.

Published
2021
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6. Preoperative prognostic predictors and treatment strategies for surgical procedure focused on the sequential organ failure assessment score in nonocclusive mesenteric ischemia: a multicenter retrospective cohort study

Author

Murata, Takaaki, primary, Yamaguchi, Nobuo, additional, Shimomoto, Yutaro, additional, Mikajiri, Yumi, additional, Sasaki, Yuki, additional, Konagaya, Kensuke, additional, Igarashi, Yuto, additional, Sawamura, Naoki, additional, Yamamoto, Kota, additional, Kume, Nao, additional, Suno, Yuma, additional, Kurata, Shuji, additional, Kasetani, Tetsuya, additional, Kato, Ichiro, additional, Nishida, Tomoki, additional, Hirata, Hirohisa, additional, Miyake, Katsunori, additional, Oonishi, Takahisa, additional, Isogai, Naoko, additional, Fukai, Ryuta, additional, Kanomata, Hiroyuki, additional, Shimoyama, Rai, additional, Kashiwagi, Hiroyuki, additional, Takenoue, Tomohiro, additional, Terashima, Takahiro, additional, Murayama, Hiroyuki, additional, Kohriki, Shunsaku, additional, Morita, Takeshi, additional, Takaki, Mutsuo, additional, Ogino, Hidemitsu, additional, Kanemaru, Takayuki, additional, Sano, Ken, additional, Kurogi, Norimitsu, additional, Watanabe, Kazunao, additional, Hirata, Masahiro, additional, and Kawachi, Jun, additional

Published
2023
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8. Long-term Results of a Heparin-bonded Expanded Polytetrafluoroethylene Grafts for Above-the-knee Femoropopliteal Bypasses: A Japanese Prospective Multicenter Registry

Author

Fujimura, Naoki, primary, Obara, Hideaki, additional, Matsubara, Kentaro, additional, Toya, Naoki, additional, Isogai, Naoko, additional, Ogino, Hidemitsu, additional, Fujii, Taku, additional, Kudo, Toshifumi, additional, Kanaoka, Yuji, additional, Harada, Hirohisa, additional, Uchiyama, Hidetoshi, additional, Guntani, Atsushi, additional, Shimogawara, Tatsuya, additional, Shibutani, Shintaro, additional, and Ohki, Takao, additional

Published
2023
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10. IN.PACT AV access randomized trial: Japan cohort outcomes through 12 months.

Author

Haruguchi, Hiroaki, Suemitsu, Kotaro, Isogai, Naoko, Murakami, Masaaki, Fujihara, Masahiko, Iwadoh, Kazuhiro, Menk, Jeremiah, Ookubo, Hiroko, and Ogawa, Tomonari

Subjects
TRANSLUMINAL angioplasty, ARTERIOVENOUS fistula, ASIANS, CRIME & the press
Abstract

Purpose: There is a lack of adjudicated and prospectively randomized published outcomes on the use of drug‐coated balloons (DCB) to treat dysfunctional arteriovenous fistula in Asian patients. This post hoc subgroup analysis of 112 Japanese participants from the global IN.PACT AV Access trial reports outcomes through 12 months. Materials and Methods: Participants were treated with DCB (n = 58) or standard non‐coated percutaneous transluminal angioplasty (PTA) balloons (n = 54). Outcomes included target lesion primary patency (TLPP), access circuit primary patency, and safety. Results: Through 6 months, TLPP was 86.0% (49/57) in the DCB group and 49.1% (26/53) in the PTA group (p < 0.001). Through 12 months, TLPP was 67.3% (37/55) in the DCB group and 43.4% (23/53) in the PTA group (p = 0.013). Conclusion: In this post hoc analysis of Japanese participants from the IN.PACT AV Access trial, participants treated with DCB had higher TLPP through 6 and 12 months compared with PTA. [ABSTRACT FROM AUTHOR]

Published
2023
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11. 1-Year Outcomes of Thromboendarterectomy vs Endovascular Therapy for Common Femoral Artery Lesions

Author

Nakama, Tatsuya, primary, Takahara, Mitsuyoshi, additional, Iwata, Yo, additional, Fujimura, Naoki, additional, Yamaoka, Terutoshi, additional, Suzuki, Kenji, additional, Obunai, Kotaro, additional, Tan, Michinao, additional, Shibata, Tsuyoshi, additional, Horie, Kazunori, additional, Sasaki, Shinya, additional, Akamatsu, Daijirou, additional, Takahashi, Hiroki, additional, Yamamoto, Yoshito, additional, Yasuto, Hoshino, additional, Aihara, Hideaki, additional, Uchiyama, Hidetoshi, additional, Kodama, Takahide, additional, Tabata, Minoru, additional, Ohara, Hideaki, additional, Matsubara, Kentaro, additional, Kamiya, Yuki, additional, Sekimoto, Yasuhito, additional, Igari, Kimihiro, additional, Umemoto, Tomoyuki, additional, Jujo, Kentaro, additional, Matsui, Akihiro, additional, Shintani, Yoshiaki, additional, Kotani, Shinsuke, additional, Hozawa, Koji, additional, Hideto, Yano, additional, Ueshima, Daisuke, additional, Ozaki, Dai, additional, Hayakawa, Naoki, additional, Doijiri, Tatsuki, additional, Tobita, Kazuki, additional, Shimogawara, Tatsuya, additional, Mouri, Shinsuke, additional, Araki, Hiroshi, additional, Yamauchi, Yasutaka, additional, Anzai, Hitoshi, additional, Shintani, Tsunehiro, additional, Hayashi, Masanori, additional, Kato, Tamon, additional, Shinozaki, Norihiko, additional, Banno, Hiroshi, additional, Kojima, Tai, additional, Fujihara, Masahiko, additional, Iida, Osamu, additional, Hata, Yosuke, additional, Kawasaki, Daizo, additional, Nakamura, Jun, additional, Kimura, Masayoshi, additional, Tsubakimoto, Yoshinori, additional, Yamaguchi, Shinichiro, additional, Ichihashi, Shigeo, additional, Tanaka, Hiroyuki, additional, Kobayashi, Taira, additional, Furuyama, Tadashi, additional, Morisaki, Koichi, additional, Makoto, Sugihara, additional, Imoto, Yuki, additional, Doi, Hideki, additional, Suematsu, Nobuhiro, additional, Ito, Hiroyuki, additional, Okadome, Jun, additional, Kyuragi, Ryoichi, additional, Ogata, Kenji, additional, Hayashi, Keita, additional, Fujii, Taku, additional, Isogai, Naoko, additional, and Karashima, Eiji, additional

Published
2022
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13. Stomach resection with intraoperative fluoroscopy in laparoscopic distal gastrectomy for early gastric cancer

Author

Kawachi, Jun, Kashiwagi, Hiroyuki, Ogino, Hidemitsu, Isogai, Naoko, Shimoyama, Rai, Fukai, Ryuta, Miyake, Katsunori, Sasaki, Akiko, Terashima, Takahiro, Teshima, Shinichi, and Watanabe, Kazunao

Subjects
Stomach cancer -- Diagnosis -- Care and treatment, Gastrectomy -- Methods -- Patient outcomes, Fluoroscopy -- Methods -- Patient outcomes, Health
Abstract

Byline: Jun. Kawachi, Hiroyuki. Kashiwagi, Hidemitsu. Ogino, Naoko. Isogai, Rai. Shimoyama, Ryuta. Fukai, Katsunori. Miyake, Akiko. Sasaki, Takahiro. Terashima, Shinichi. Teshima, Kazunao. Watanabe Background: In Japan, laparoscopic distal gastrectomy (LDG) [...]

Published
2018

16. Pneumothorax with coronavirus disease 2019 in non-ventilated patients: a single-center retrospective case series

Author

kawachi, jun, primary, Koyama, Hiroshi, additional, Aida, Yoshihisa, additional, Kamio, Tadashi, additional, Yamagami, HIroshi, additional, Nishiguchi, Shou, additional, Ichita, Chikamasa, additional, Shimoyama, Rai, additional, Isogai, Naoko, additional, Miyake, Katsunori, additional, Murata, Takaaki, additional, Nishida, Tomoki, additional, Sunou, Yuma, additional, Igarashi, Yuto, additional, Fukai, Ryuta, additional, and Kashiwagi, Hiroyuki, additional

Published
2021
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18. Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study

Author

Miyake, Katsunori, primary, Iwagami, Masao, additional, Ohtake, Takayasu, additional, Moriya, Hidekazu, additional, Kume, Nao, additional, Murata, Takaaki, additional, Nishida, Tomoki, additional, Mochida, Yasuhiro, additional, Isogai, Naoko, additional, Ishioka, Kunihiro, additional, Shimoyama, Rai, additional, Hidaka, Sumi, additional, Kashiwagi, Hiroyuki, additional, Kawachi, Jun, additional, Ogino, Hidemitsu, additional, and Kobayashi, Shuzo, additional

Published
2020
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19. Additional file 3 of Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study

Author

Miyake, Katsunori, Iwagami, Masao, Ohtake, Takayasu, Moriya, Hidekazu, Kume, Nao, Murata, Takaaki, Nishida, Tomoki, Mochida, Yasuhiro, Isogai, Naoko, Ishioka, Kunihiro, Rai Shimoyama, Hidaka, Sumi, Kashiwagi, Hiroyuki, Kawachi, Jun, Ogino, Hidemitsu, and Kobayashi, Shuzo

Subjects
urogenital system, urologic and male genital diseases, female genital diseases and pregnancy complications
Abstract

Additional file 3. Multivariable logistic regression analysis by level of baseline kidney function and acute kidney injury status. AKI = acute kidney injury, eGFR = estimated glomerular filtration rate, ESRD = end-stage renal disease.

Published
2020
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20. Additional file 2 of Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study

Author

Miyake, Katsunori, Iwagami, Masao, Ohtake, Takayasu, Moriya, Hidekazu, Kume, Nao, Murata, Takaaki, Nishida, Tomoki, Mochida, Yasuhiro, Isogai, Naoko, Ishioka, Kunihiro, Rai Shimoyama, Hidaka, Sumi, Kashiwagi, Hiroyuki, Kawachi, Jun, Ogino, Hidemitsu, and Kobayashi, Shuzo

Subjects
education, health care economics and organizations
Abstract

Additional file 2. List of International Classification Disease of 10th revision codes to classify indication for surgery.

Published
2020
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21. Additional file 1 of Association of pre-operative chronic kidney disease and acute kidney injury with in-hospital outcomes of emergency colorectal surgery: a cohort study

Author

Miyake, Katsunori, Iwagami, Masao, Ohtake, Takayasu, Moriya, Hidekazu, Kume, Nao, Murata, Takaaki, Nishida, Tomoki, Mochida, Yasuhiro, Isogai, Naoko, Ishioka, Kunihiro, Rai Shimoyama, Hidaka, Sumi, Kashiwagi, Hiroyuki, Kawachi, Jun, Ogino, Hidemitsu, and Kobayashi, Shuzo

Abstract

Additional file 1. List of 38 hospitals in the Tokushukai Medical Database.

Published
2020
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36. Dual port distal gastrectomy

Author

Kashiwagi, Hiroyuki, primary, Kawachi, Jun, additional, Isogai, Naoko, additional, Yamanashi, Takako, additional, Miyake, Katsunori, additional, Shimoyama, Rai, additional, Fukai, Ryota, additional, Terada, Yasushi, additional, and Ogino, Hidemitsu, additional

Published
2017
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38. Fatal liver gas gangrene after biliary surgery

Author

Miyata, Yui, primary, Kashiwagi, Hiroyuki, additional, Koizumi, Kazuya, additional, Kawachi, Jun, additional, Kudo, Madoka, additional, Teshima, Shinichi, additional, Isogai, Naoko, additional, Miyake, Katsunori, additional, Shimoyama, Rai, additional, Fukai, Ryota, additional, and Ogino, Hidemitsu, additional

Published
2017
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41. Evaluating the Effectiveness and Clinical Outcomes of Endovascular Aneurysm Repair-First Approach for Ruptured Abdominal Aortic Aneurysm in Japan

Author

Ogino, Hidemitsu, Isogai, Naoko, Kume, Nao, Shibutani, Shintaro, Yashiro, Hideki, Takahara, Mitsuyoshi, and Fujimura, Naoki

Abstract

Purpose: To verify the validity of an endovascular aneurysm repair (EVAR)-first strategy for treating patients with ruptured abdominal aortic aneurysm (rAAA) in Japan.Materials and methods: This study was conducted on 2 groups of patients with rAAA who underwent surgical treatment at 3 hospitals in the Kanagawa Prefecture, Japan, between January 2007 and September 2016. The open surgical treatment group comprised patients with rAAA who underwent open surgical treatment before January 2012; their data were retrospectively collected from their medical records. The EVAR-first strategy group comprised patients with rAAA who underwent treatment based on the Shonan rAAA protocol (SRAP; the standard protocol-based EVAR-first strategy) in or after February 2012; their data were collected prospectively. The short- and long-term treatment outcomes of both groups were compared. In addition, a risk score-based sensitivity analysis (one-to-one matching) was conducted on both groups using a caliper with 0.2 standard deviations of the score.Results: Of the 163 patients with rAAA, the open surgical and EVAR-first strategy groups comprised 53 and 110 patients, respectively (EVAR: 91.8%, open repair: 8.2%). The 30-day postoperative mortality rate differed significantly, being 42% for the open surgery group and 25% for the EVAR-first strategy group (odds ratio: 0.44, 95% confidence interval: 0.20–0.97). The postoperative survival rates at 6 months, 1 year, and 3 years were 66%, 48%, and 58% for the EVAR-first group, respectively, and 51%, 66%, and 48% for the open surgery group, respectively (p=0.072). In a matched cohort analysis (n=50), the 30-day postoperative mortality rate was 22% for the EVAR-first group and 44% for the open surgery group (odds ratio: 0.35, 95% confidence interval: 0.14–0.90). The postoperative survival rates at 6 months, 1 year, and 3 years were 76%, 76%, and 63% for the EVAR-first group, respectively, and 48%, 45%, and 45% for the open surgery group, respectively (p=0.003).Conclusion: The SRAP-based EVAR-first strategy for rAAA yielded significantly better treatment outcomes than the open surgical strategy. These findings suggest that EVAR should be considered the primary treatment option for rAAA, given its potential to reduce early mortality rates.Clinical Impact Multicenter retrospective analysis of prospectively collected registry data was done to compare treatment outcomes of two groups of ruptured abdominal aortic aneurysm patients open surgery and endovascular-aneurysm-repair (EVAR)–first strategy (Shonan ruptured abdominal aortic aneurysm protocol). EVAR-first group showed better outcomes: lower 30-day mortality (25% vs. 42%), higher survival rates at 6 months, 1 year, and 3 years. Take home Message: The study supports the use of the EVAR-first strategy with the Shonan Protocol for treating ruptured abdominal aortic aneurysms in Japan, showing improved outcomes, reduced 30-day postoperative mortality, and better long-term survival rates compared to the conventional approach.

Published
2024
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47. Long-Term Outcomes of a Japanese Prospective Multicenter Registry Using a Heparin-Bonded Expanded Polytetrafluoroethylene Graft for Above-the-Knee Femoropopliteal Bypasses.

Author

Fujimura N, Obara H, Matsubara K, Toya N, Isogai N, Ogino H, Fujii T, Kudo T, Kanaoka Y, Harada H, Uchiyama H, Guntani A, Shimogawara T, Watada S, Shibutani S, and Ohki T

Subjects
Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Amputation, Surgical, Blood Vessel Prosthesis Implantation instrumentation, Coated Materials, Biocompatible, East Asian People, Japan, Limb Salvage, Prospective Studies, Prosthesis Design, Registries, Time Factors, Treatment Outcome, Blood Vessel Prosthesis, Femoral Artery surgery, Femoral Artery diagnostic imaging, Femoral Artery physiopathology, Heparin administration & dosage, Peripheral Arterial Disease surgery, Peripheral Arterial Disease physiopathology, Peripheral Arterial Disease diagnostic imaging, Polytetrafluoroethylene, Popliteal Artery surgery, Popliteal Artery physiopathology, Popliteal Artery diagnostic imaging, Vascular Patency
Abstract

Background: Despite the widespread use of PROPATEN ® , a bioactive heparin-bonded expanded polytetrafluoroethylene graft, in bypass surgery, there are only a few reports of long-term results. We evaluated the long-term results of PROPATEN ® use for above-knee femoropopliteal bypass (AKFPB)., Methods and Results: After PROPATEN ® -based AKFPB, patients were prospectively registered at 20 Japanese institutions between July 2014 and October 2017 to evaluate long-term results. During the median follow-up of 76 months (interquartile range 36-88 months) for 120 limbs (in 113 patients; mean [±SD] age 72.7±8.1 years; 66.7% male; ankle-brachial index [ABI] 0.45±0.27; lesion length 26.2±5.7 cm; chronic limb-threatening ischemia in 45 limbs), there were 8 major amputations; however, clinical improvement was sustained (mean [±SD] ABI 0.87±0.23) and the Rutherford classification grade improved in 105 (87.5%) limbs at the latest follow-up. At 8 years, the primary patency, freedom from target-lesion revascularization, secondary patency, survival, and amputation-free survival, as estimated by the Kaplan-Meier method, were 66.3±4.8%, 71.5±4.4%, 86.5±3.4%, 53.1±5.0%, and 47.4±5.3%, respectively., Conclusions: This multicenter prospective registry-based analysis showed sustained excellent clinical improvement and secondary patency for up to 8 years following PROPATEN ® -based AKFPB. PROPATEN ® constitutes a durable and good revascularization option for complex superficial femoral artery lesions, especially when endovascular treatment is inappropriate or an adequate venous conduit is unavailable.

Published
2024
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48. A Surgical Case of Bronchial Artery Aneurysm Connecting to a Pulmonary Artery and Vein Complicated by Racemose Hemangioma.

Author

Nishida T, Isogai N, Shimoyama R, Kawachi J, Tsukiyama T, Noguchi KI, and Fukai R

Subjects
Aged, 80 and over, Bronchial Arteries abnormalities, Bronchial Arteries diagnostic imaging, Bronchial Arteries surgery, Female, Humans, Pulmonary Artery abnormalities, Pulmonary Artery diagnostic imaging, Pulmonary Artery surgery, Treatment Outcome, Aneurysm complications, Aneurysm diagnostic imaging, Embolization, Therapeutic, Hemangioma complications, Hemangioma diagnostic imaging, Hemangioma surgery
Abstract

We report a surgical case of bronchial artery aneurysm (BAA) that directly connected to a pulmonary artery and a pulmonary vein through an abnormal vessel. It was complicated by racemose hemangioma. This is a rare vascular malformation. An 82-year-old female had a large BAA that was found incidentally. First, we consider treating the BAA with embolization by interventional radiology (IVR). However, because of strong meandering of the bronchial artery, we could not advance a microcatheter into the BAA. Therefore, a surgical operation was performed through a standard posterior lateral thoracotomy. The BAA was located between the upper and lower lobes and directly connected to the pulmonary artery. Some bronchial artery branches that provided inflow to the aneurysm were ligated, and the abnormal vessel that connected the BAA to the upper pulmonary vein was ligated easily. A fistula between the BAA and pulmonary artery was sutured by the cardiovascular surgeon using an artificial cardiopulmonary device, with permissive stenosis of A2b (ascending A2).

Published
2022
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49. Midterm Results of a Japanese Prospective Multicenter Registry of Heparin-Bonded Expanded Polytetrafluoroethylene Grafts for Above-the-Knee Femoropopliteal Bypass.

Author

Shibutani S, Obara H, Matsubara K, Toya N, Isogai N, Ogino H, Watada S, Asami A, Kudo T, Kanaoka Y, Fujimura N, Harada H, Uchiyama H, Sato Y, and Ohki T

Subjects
Adult, Aged, Aged, 80 and over, Anticoagulants adverse effects, Blood Vessel Prosthesis Implantation adverse effects, Critical Illness, Female, Femoral Artery diagnostic imaging, Femoral Artery physiopathology, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular physiopathology, Graft Occlusion, Vascular surgery, Heparin adverse effects, Humans, Ischemia diagnostic imaging, Ischemia physiopathology, Japan, Male, Middle Aged, Peripheral Arterial Disease diagnostic imaging, Peripheral Arterial Disease physiopathology, Popliteal Artery diagnostic imaging, Popliteal Artery physiopathology, Prospective Studies, Registries, Time Factors, Treatment Outcome, Vascular Patency, Anticoagulants administration & dosage, Blood Vessel Prosthesis, Blood Vessel Prosthesis Implantation instrumentation, Coated Materials, Biocompatible, Femoral Artery surgery, Heparin administration & dosage, Ischemia surgery, Lower Extremity blood supply, Peripheral Arterial Disease surgery, Polytetrafluoroethylene, Popliteal Artery surgery
Abstract

Background: This study prospectively analyzed the midterm results of above-the-knee femoropopliteal bypass (AKb) using bioactive heparin-bonded expanded polytetrafluoroethylene (HB-ePTFE) graft in patients with femoropopliteal occlusive disease., Methods and results: This prospective, multicenter, non-randomized study reviewed limbs undergoing AKb with HB-ePTFE graft for femoropopliteal lesion in 20 Japanese institutions between July 2014 and October 2017. Primary efficacy endpoints were primary, primary assisted, and secondary graft patency. Safety endpoints included any major adverse limb event and perioperative mortality. During the study period, 120 limbs of 113 patients (mean age, 72.7 years) underwent AKb with HB-ePTFE grafts. A total of 45 patients (37.5%) had critical limb ischemia and 17 (15.0%) were on hemodialysis (HD). Median duration of follow-up was 16 months (range, 1-36 months). Estimated 1- and 2-year primary, primary assisted, and secondary graft patency rates were 89.4% and 82.7%, 89.4% and 87.2%, and 94.7% and 92.5%, respectively. On univariate analysis of 2-year primary graft patency, having 3 run-off vessels, cuffed distal anastomoses, no coronary artery disease, and no chronic kidney disease requiring HD were significantly associated with favorable patency., Conclusions: AKb using HB-ePTFE grafts achieved favorable 2-year graft patency. AKb using HB-ePTFE grafts may therefore be an acceptable, highly effective treatment option for femoropopliteal artery lesions.

Published
2020
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50. [Successful Treatment of Empyema with Bronchial Fistulas by Filling under Thoracoscopic Observation; Report of a Case].

Author

Fukai R, Sugimoto H, Kashiwagi H, Ogino H, Shimoyama R, Kawachi J, Ikegaya Y, Isogai N, Miyake K, Nishimura S, Nakagawa M, and Watanabe K

Subjects
Aged, 80 and over, Humans, Male, Omentum, Thoracoscopy, Tomography, X-Ray Computed, Treatment Outcome, Bronchial Fistula surgery, Empyema surgery
Abstract

Empyema with fistula usually resists conservative treatment such as thoracic cavity drainage and administration of antibacterial agents, thus it often requires surgeries such as fenestration, omental/muscle filling, and thoracoplasty. However, due to advanced age and poor condition, conducting invasive surgeries is often difficult in elderly patients. We report a case with the improvement of empyema by bronchial filling with endobronchial Watanabe spigot (EWS) under thoracoscopic observation for an 89-year-old patient who had developed chronic empyema with a bronchial fistulas. After filling EWS, air-leakage from bronchial fistula disappeared and the patient could discharged from the hospital successfully.

Published
2015

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