[Surgery of large bullous emphysema--functional results]

Forty eight patients suffering from a bulla compressing the rest of the lung tissue were examined before and after the resection of the bulla with the aim to estimate the degree of functional improvement and to find out criteria of indication for surgical treatment. The follow-up examinations included the clinical symptoms, functional data and the size of the bulla in an early phase and a late phase. The size of the bulla was determined on the basis of chest x-ray by planimetry. The analysis of preoperative and postoperative functional data (bodyplethysmography, spirometry, blood gas analysis, ergometry, measurement of pulmonary artery pressure) were performed in consideration of the surgical method and the presence of chronic obstructive lung disease. The comparison of the preoperative and postoperative values showed an improvement of the respiratory function, the gas exchange and the degree of dyspnea. The size of the bulla and the degree of the functional restriction are the decisive criteria for surgical treatment.