Chest
Clinical InvestigationsFunctional Results of Surgery for Bullous Emphysema
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MATERIAL AND METHODS
Forty-six patients with bullous emphysema underwent surgery and have had long-term follow-up of pulmonary function at five years.
Standard chest roentgenogram and computed tomography were performed in all patients for diagnostic purposes and to measure the size and volume of the bullae by computed planimetry as described (Fig 1).10
Eighteen patients (16 male and 2 female subjects), aged 15 to 73 years (mean 41), had gigantic bilateral bullae occupying more than one-third (63.4 ± 15.3) of the
RESULTS
All patients had improved subjectively. There were no further episodes of spontaneous pneumothorax. No new bullae were detected on chest roentgenogram and computed tomography.
DISCUSSION
Conservative surgery in the patients with bullae exceeded one third of the hemithorax and did not impair lung function immediately after operation. As all operations in this group were bilateral bullectomies via a median sternotomy, we conclude that the trans-sternal approach does not worsen respiratory function. Others found the same.19
Lung function in the patients with bullae occupying less than one third of the hemithorax deteriorated more following surgery than in group 1. Allowing
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Manuscript received October 2; revision accepted April 22.