[Surgery of giant bullae of emphysema in adults]

Over a 20 years period 50 patients with giant emphysematous bullae (bilateral in 20 cases) were operated upon. Fifteen had been exposed to an occupational risk (coal mining, steel milling, chemicals); all were, or had been, tobacco smokers; 11 were in acute respiratory distress at the time of surgery. Respiratory function tests showed mixed restrictive and obstructive impairment. Ten patients had chronic cor pulmonale. There were 8 post-operative deaths, 4 of them with right-sided heart failure. Mortality was highest in patients with bilateral lesions and in emergency situations. Late complications involved the lungs in 10 cases and the heart in 2 cases. The results of pre- and post-operative lung function tests could be compared in 13 patients.