Bullectomy for symptomatic or complicated giant lung bullae

Area of Science:

• Thoracic Surgery
• Pulmonary Medicine
• Surgical Outcomes

Background:

• Giant bullae of the lung are rare conditions.
• Limited data exists on functional outcomes following surgical intervention for giant bullae.

Purpose of the Study:

• To evaluate the functional results and complications associated with surgical treatment of giant bullae.

Main Methods:

• Retrospective review of patients who underwent surgery for giant bullae between December 1988 and December 2010.
• Analysis of patient demographics, bulla size, surgical procedures, complications, and pulmonary function tests (PFTs).

Main Results:

• 63 patients (median age 56 years) with median bulla size of 14 cm underwent surgery.
• Bullectomy was the most common procedure (54 patients).
• Pulmonary function improved postoperatively, with a significant increase in forced expiratory volume in 1 second (FEV1) from 1.0 L to 1.4 L (p=0.002).
• Complications occurred in 43% of patients; increasing bulla size and underlying emphysema were associated with increased morbidity.
• Dyspnea improved in 67.4% of patients.

Conclusions:

• Bullectomy offers improved pulmonary function for patients with symptomatic or complicated giant bullae.
• Larger bulla size and underlying diffuse emphysema are linked to higher treatment morbidity.
• Underlying diffuse emphysema should not be considered a contraindication for bullectomy.