Surgical treatment for giant emphysematous bullae

Abstract

From 1971 to December 1992, 33 patients underwent surgical treatment for emphysematous giant bullae in Nagasaki University Hospital. Naclerio-Langer's pneumorraphy method and partial resection of the lung followed by autosuturing were performed. In 8 patients with bilateral giant bullae, simultaneous bilateral surgery was performed through mid sternal incision. Video-assisted thoracic surgery was used in two recently treated patients with bilateral lesions. Symptomatic relief was good in 78% of those with Hugh-Jones II-V dyspnea. After surgery, FEV1.0% improved greatly. In 69% of the patients whose FEV1.0% was over 50%, postoperative lung function remained good during the follow-up period. Patients with severe obstructive lung disease experienced short-term improvement of dyspnea, but then their condition deteriorated gradually. On the basis of these findings, we discuss the indications for surgery.