Elective Surgery for Giant Bullous Emphysema

Palla, Antonio; Desideri, Massimiliano; Rossi, Giuseppe; Bardi, Giulio; Mazzantini, D.; Mussi, Alfredo; Giuntini, C.

doi:10.1378/chest.128.4.2043

Cited by 91 publications

(31 citation statements)

References 30 publications

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“…As the bullae do not take part in gas exchange and occupy space, they lead to impairment of ventilation and cause worsening dyspnea. In patients with a giant bulla, surgical bullectomy is the treatment of choice2. In 1937, Burke1 described first case of "vanishing lungs" in a 35-year-old man who experienced progressive dyspnea, respiratory failure, and radiographic and pathologic findings of giant bullae, which occupied two-thirds of both hemithoraces.…”

Section: Introductionmentioning

confidence: 99%

A Case of Bilateral Giant Bullae in Young Adult

et al. 2013

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Giant bullae are large bullae occupying at least one-third of the hemithorax and surgical bullectomy is the treatment of choice. We report a case with symptomatic giant bullae which were resected successfully. A 35-year-old man presented with bilateral giant bullae that occupied almost the entire left hemithorax and a third of the right hemithorax. He was a current smoker with a 30 pack-year history and he presented with dyspnea on exertion. An elective surgical bullectomy was performed with video-assisted thoracoscopic surgery. The patient recovered without any adverse events and stayed well for 1 month after surgery.

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Section: Introductionmentioning

confidence: 99%

A Case of Bilateral Giant Bullae in Young Adult

et al. 2013

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“…An air space in the lung measuring more than 1 centimeter in diameter is defined as a bulla, which consists of nonventilated air pockets formed by compressed and attenuated lung tissue 1,2. This entity is highly associated with emphysema, which is most commonly caused by smoking.…”

Section: Introductionmentioning

confidence: 99%

“…Air fluid levels inside bullae are an unusual complication of chronic obstructive pulmonary disease and the therapeutic antibiotics or broncoscopy have not been evaluated 3. Giant bullous emphysema, occupying large portions of the hemithorax, can be treated with bullectomy when lung-function is affected and improvement has been seen in the intermediate and long-term follow up 2,4–7. Localized bullae have shown better results with bullectomy as oppose to medical management 8.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Collapse of Bilateral Bullae with Conservative Management

Shariff

Singh

Daniele

et al. 2013

Clin Med Insights Case Rep

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We report a case of bilateral apical lung bullae that collapsed following an episode of community-acquired pneumonia with bilateral air fluid levels. With standard treatment for community-acquired pneumonia, management of a patient that may have qualified for bullectomy, (as in our case) showed complete resolution of all pathology without surgical intervention. Conservative management took precedence in alleviating pathology over surgical intervention.

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“…Strange therefore that there is so little in the literature on the treatment of this distinct patient group, particularly as results following surgical bullectomy can be spectacular and genuinely life-changing in individual patients, with evidence to show persistence of benefit out to at least 5 years [5]. Figures for the UK, however, show an average of fewer than 200 procedures a year across 3 annual audits from 2011-2012 to 2013-2014 [6], with one major unit reporting only 20 such procedures over a 12-year period [7].…”

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confidence: 99%

“…Not everybody either wants or is fit for surgical intervention, and, perhaps slightly surprisingly, the interventional pulmonology community has been a little late to the table. This is probably due to the received wisdom that surgical treatment of giant bullae gives universally excellent results, but what evidence there is does not necessarily support this view even in stable patients [5]. …”

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confidence: 99%