The use of Watanabe spigots in the management of bronchoesophageal fistulas

Summary: Bronchoesophageal and bronchogastric fistulas are rare complications of thoracic surgery as esophagectomy, malignancy or prolonged endotracheal intubation. Although uncommon, their morbidity and mortality is substantial. Treatment of these fi stulas is challenging and often lengthy with limited success rates. Endoscopic treatment may be the treatment of choice for some types of fi stulas, but despite a variety of methods available, the success rate is relatively low with little consistent data about its eff ectiveness. At the same time, new technologies and devices have become available with a potential to address these complicated conditions. One of them are Watanabe spigots, initially used in pneumology for the treatment of persistent pneumothorax and pyothorax with bronchial fi stula. In the presented case reports Watanabe spigots are used in combination with over-the-scope clips in two of our patients with bronchoesophageal fi stulas fol lowing esophagectomy with promising results. We also present an overview of endoscopic methods of therapy in the context of and separately discuss available evidence about the possibilities of the use of Watanabeho spigots in the treatment of bronchoesophageal fi stulas. Key words: bronchoesophageal fi stula – Watanabe spigot – esophagectomy – over-the-scope clip