Acta Med. 1999, 42: 111-114

Surgery for Bullous Emphysema

Jiří Šimeka, Milan Rešlb, Bohuslav Králc

aCharles University in Prague, Faculty of Medicine in Hradec Králové, Department of Cardiosurgery, Hradec Králové, Czech Republic
bCharles University in Prague, Faculty of Medicine in Hradec Králové, The Fingerland Department of Pathology, Hradec Králové, Czech Republic
cUniversity Teaching Hospital, Second Department of Internal Medicine, Hradec Králové, Czech Republic

Received February 1, 1999
Accepted June 1, 1999

The present indications for surgery are mainly large or increasing bullae that result in compression of apparently good lung tissue, and the complications of bullous diseases such as pneumothorax. The results of local resection of localized giant bullae are dramatic. The resection of small bullae generally has little effect on lung function. Lobectomy should not be done until bullae have been removed locally and the remaining lung has been tested by positive ventilation. The indications for the resection of large bullae in the presence of diffuse emphysema require very careful individual study. Pulmonary function tests are mandatory but computed tomography is the single most useful method of assesing the extent of the bullous disease and the underlying lung disease. If the underlying lung is diffusely cystic then any surgical treatment is palliative only.


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