{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T04:59:20Z","timestamp":1782363560819,"version":"3.54.5"},"reference-count":6,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["surg case rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Refractory pyothorax caused by methicillin-resistant <jats:italic>Staphylococcus aureus<\/jats:italic> (MRSA) is a challenging clinical condition; complications such as bronchopleural fistulae can further hinder its treatment. To avoid a fatal state caused by aspirating pneumonia, open window thoracotomy is not only sometimes performed, but subsequent closure of the window can also be difficult. In this report, we describe the case of a patient with MRSA pyothorax with bronchopleural fistula in whom a successful closure of window thoracostomy was achieved by utilizing Endobronchial Watanabe Spigot\u3000(EWS; Novatech, La Ciotat, France) bronchial occlusion and a modified extraperiosteal air plombage technique.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>A 66-year-old man underwent an open window thoracotomy for pyothorax with bronchopleural fistula with MRSA infection at the age of 59. After 7 years, he was referred to our department for the closure of the window. Initially, we occluded the right B6a\u2009+\u2009b by EWS under bronchoscopy. Subsequently, we dissected the intercostal muscles between the 3rd, 4th, 5th, and 6th ribs to collapse the pyothorax cavity and ensure the coverage of the fistula of lung including the hypertrophied parietal pleura and soft tissues of the chest wall. We filled the extrapleosteal space with a pedicled anterior serratus muscle flap to compress the parietal pleura. Postoperatively, lung expansion was satisfactory, and there has been no recurrence for 6 years since the window closure surgery.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>We were able to achieve closure and healing in a patient who underwent open window thoracostomy for MRSA bronchopleural fistula by applying EWS and modified extraperiosteal air plombage technique.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40792-024-01815-y","type":"journal-article","created":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T03:02:23Z","timestamp":1705460543000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Closure of open window thoracostomy due to MRSA pyothorax by EWS bronchial occlusion and modified extraperiosteal air plombage: a case report"],"prefix":"10.1186","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0009-5331-3717","authenticated-orcid":false,"given":"Masami","family":"Kuramochi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mayumi","family":"Shinonaga","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Setsuo","family":"Kuraoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,1,17]]},"reference":[{"issue":"4","key":"1815_CR1","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/S0096-5588(20)30040-4","volume":"37","author":"JW Pate","year":"1959","unstructured":"Pate JW, Hughes FA Jr, Campbell RE, Reisser JM. Air plombage with resection for pulmonary tuberculosis; a technique for decreasing complications. J Thorac Surg. 1959;37(4):435\u201341.","journal-title":"J Thorac Surg"},{"issue":"12","key":"1815_CR2","first-page":"627","volume":"52","author":"S Iioka","year":"1977","unstructured":"Iioka S, Sawamura K, Nagaoka Y, Chikamori J, Mori T, Nanjo S, Nakamura K, Masaoka A, Kimura K. A new surgical method for chronic empyema\u2013application of the extraperiosteal \u201cair-plombage\u201d procedure. Kekkaku. 1977;52(12):627\u201333.","journal-title":"Kekkaku"},{"issue":"4","key":"1815_CR3","doi-asserted-by":"publisher","first-page":"264","DOI":"10.1097\/00128594-200310000-00005","volume":"10","author":"Y Watanabe","year":"2003","unstructured":"Watanabe Y, Matsuo K, Tamaoki A, Komoto R, Hiraki S. Bronchial occlusion with endobronchial watanabe spigot. J Bronchol. 2003;10(4):264\u20137.","journal-title":"J Bronchol"},{"key":"1815_CR4","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1007\/s00380-006-0921-5","volume":"21","author":"T Kato","year":"2006","unstructured":"Kato T, Takagi H, Matsuno Y, Imaizumi M, Umemoto T. High-pressure irrigation and gentian-violet application for mediastinitis following replacement of ascending aorta and aortic valve. Heart Vessels. 2006;21:392\u20134.","journal-title":"Heart Vessels"},{"key":"1815_CR5","doi-asserted-by":"publisher","first-page":"30","DOI":"10.1016\/j.resinv.2014.09.002","volume":"53","author":"H Kaneda","year":"2015","unstructured":"Kaneda H, Minami K, Nakano T, Taniguchi Y, Saito T, Konobu T, et al. Efficacy and long-term clinical outcome of bronchial occlusion with endobronchial Watanabe spigots for persistent air leaks. Respir Investig. 2015;53:30\u20136.","journal-title":"Respir Investig"},{"issue":"1","key":"1815_CR6","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1186\/s40792-021-01144-4","volume":"7","author":"M Iwasaki","year":"2021","unstructured":"Iwasaki M, Shimomura M, Ii T. Negative-pressure wound therapy in combination with bronchial occlusion to treat bronchopleural fistula: a case report. Surg Case Rep. 2021;7(1):61.","journal-title":"Surg Case Rep"}],"container-title":["Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01815-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40792-024-01815-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40792-024-01815-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T03:11:12Z","timestamp":1705461072000},"score":1,"resource":{"primary":{"URL":"https:\/\/surgicalcasereports.springeropen.com\/articles\/10.1186\/s40792-024-01815-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,17]]},"references-count":6,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["1815"],"URL":"https:\/\/doi.org\/10.1186\/s40792-024-01815-y","relation":{},"ISSN":["2198-7793"],"issn-type":[{"value":"2198-7793","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,17]]},"assertion":[{"value":"18 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 January 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 January 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this case report and the accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"19"}}