Combined surgery for lung cancer and giant emphysematous bulla : a case report

Abstract

A 77-year-old male was admitted because of dyspnea and an abnormal chest X-ray. He had been followed for giant bulla in the left lung for 3 years. On admission, his chest roentgenogram revealed a giant bulla occupying one half of the left lung and a tumor shadow in the right upper lung field. Pulmonary function tests, including %VC, FEV ₁₀ and unilateral pulmonary artery occlusion test, demonstrated the impaired left pulmonary function.
Bronchial biopsy of the orifice of S¹ a confirmed the diagnosis of well-differentiated squamous cell carcinoma. Simultaneous operation for bilateral lung disease was successfully performed a combination of Naclerio-Langer bullectomy with a stapling device, fibrin glue for the giant emphysematous bulla in the left lower lobe and right upper lobectomy for the lung cancer (t₁n₁m₀ p-stage II) through a median sternotomy.
Surgical indications and operative techniques for giant bulla and lung cancer are discussed.