[Long-term outcome of surgically treated bullous emphysema]

The long term outcome for 88 patients with bullous emphysema who had operations was analysed from the clinical, respiratory function and occupational point of view. In order to reduce to the minimum any bias which would be likely to appear as a result of a decrease in the number of patients with time respiratory function parameters were compared to those of a restricted number of patients for whom we knew all the values for each period determined. Before the operation all the patients showed radiological signs of bullous emphysema; the respiratory function measurements in 66 of them showed bronchial obstruction with distension, hypoxaemia at rest without hypercapnia. The clinical follow up and respiratory function was spread over more years. It showed a post operative improvement in dyspnoea which was perceptible in 77% of patients at 2 years, 68% at 3 years, 60% at 4 years, 51% at 5 years, 32% at 10 years. 2/3 of the patients who were working before the operation had taken up their normal work following it. the survival levels were 86% at 1 year, 83% at 2 years, 80% at 3 years, 78% at 4 years, 77% at 5 years, 73% at 6 years, 73% at 6 years, 58% at 10 years. Of 20 patients who died 12 had died of respiratory failure. All the spirographic parameters had improved following the operation but a secondary deterioration was noted around the 5th post operative year for the vital capacity, and at the third year for residual volume, FEV 1, and the FEV 1/VC ratio as well as PAO2.(ABSTRACT TRUNCATED AT 250 WORDS)