1998 Volume 12 Issue 7 Pages 762-765
The most reliable method for bullectomy is resection of the affected lung. In the case of multiple bullae, however, this method is time-consuming and costly. Besides, bullae with broad bases are hard to resect. In contrast, most bullae are rapidly and sufficiently ablated by heat. We assessed the contribution of a newly developed elector surgical unit tip for bulla ablation. From 1995 to 1997, 79 patients (69 males and 10 females, aged 17 to 82, 67 spontaneous pneumothorax, 17 giant bulla and 6 bullous emphysemas) underwent bullectomy combined with heat ablation using the tip among 133 patients received treatment for bullae related diseases. Indication criteria for surgical bullectomy were : ruptured bulla, solitary bulla on narrow bases or pedicles, conglomerate of small to medium bullae and giant bulla. For heat bulla ablation indications were : small to medium bullae commonly confine to edge of the lung, multiple superficial bullae, bullae with broad bases distended by air inflation and bullae with broad and flat surface slightly distended by air inflation.
These bullae were shrunk with an electrocoagulator using a large ball tip 8 millimeters in diameter. Operation times averaged 106 +/-38 minutes, average chest tube duration was 4.8 + /-3.1 days, rate of complication (prolonged air leak) was 5.1% (4/79) and rate of postoperative pneumothorax was 6.3% (5/79).
Heat bulla ablation is safe and effective in managing bullae.
