Chest
Volume 101, Issue 1, January 1992, Pages 119-122
Journal home page for Chest

Clinical Investigations
Functional Results of Surgery for Bullous Emphysema

https://doi.org/10.1378/chest.101.1.119Get rights and content

Forty-six patients with bullous emphysema were operated on. Respiratory function was investigated before and immediately after surgery, and during the follow-up to five years. The larger the volume of the bullae, the less disturbances of lung function caused by their removal immediately after operation. Respiratory function improved significantly during the long-term follow-up after removal of the bullae that were more than one third of the hemithorax, but it did not change when the bullae were less than one third of the hemithorax and deteriorated after pulmonary resection for the bullae associated with long-term pneumonia. No new bullae were revealed roentgenographically at five years postoperatively.

Section snippets

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

References (0)

Cited by (0)

Manuscript received October 2; revision accepted April 22.

View full text