The results of surgical treatment of large air cysts of the lung

Woo-Ming, M.; Capel, L.H.; Belcher, John

doi:10.1016/s0007-0971(63)80018-2

Cited by 34 publications

(12 citation statements)

References 6 publications

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“…Later, N issen [9] described the now classic method of plication and 'endorrhaphy'. Since then, there have been many reports of bullous disease treated surgically, sometimes with symptomatic and physiologic improvement [10][11][12] and sometimes with little benefit [13. 14].…”

Section: Discussionmentioning

confidence: 99%

Surgery for Bullous Emphysema

FitzGerald¹,

Keelan²,

Gaensler³

1973

Respiration

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A 60-year-old man was observed for 7 years with progressive bullous emphysema that eventually rendered his right lung functionless and resulted in severe dyspnea. Thoracotomy revealed typical periacinar (paraseptal) emphysema. Excision and plication of bullae resulted in prompt relief of symptoms and return of function which were sustained during the next 5 years. The progressive course and recovery were documented by serial clinical, radiographic, physiologic and regional lung function studies. The natural evolution of bullous lung disease is reviewed as are the concomitant physiologic abnormalities and indications for surgerys

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Section: Discussionmentioning

confidence: 99%

Surgery for Bullous Emphysema

FitzGerald¹,

Keelan²,

Gaensler³

1973

Respiration

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“…A wide variety of surgical procedures have been proposed in the management of bullous emphysema, such as: intra-cavity drainage [4]; local excision of the bullae [5]; placation [6]; stapler resection [7]; and lobectomy [8]. With the increasing interest in lung-volume reduction for emphysema and the subsequent National Emphysema Treatment Trial trial [9], there has been a surge of efforts aimed at nonsurgical lung-volume reduction.…”

Section: Discussionmentioning

confidence: 99%

Transbronchial decompression of emphysematous bullae: a new therapeutic approach

Bhattacharyya¹,

Sarkar²,

S³

et al. 2007

Eur Respir J

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Bullae are common accompaniments of chronic obstructive pulmonary disease especially emphysema. They contribute to increased lung volume and worsen the mechanical disadvantage of the inspiratory muscles by increasing the residual volume (RV) and RV/total lung capacity ratio. Thus effective decompression of a large bulla or bullae is thus important to improve the lung function of affected patients and also to provide symptomatic relief. Surgery and thoracoscopy are two commonly performed procedures used to treat bullae. Although bronchoscopic lung volume reduction has been successfully accomplished for emphysema, isolated decompression of bullae bronchoscopically has not been tried to date.A large emphysematous bulla in the left lower lobe of a surgically unfit patient was bronchoscopically punctured with a transbronchial aspiration needle; the position of the needle inside the bulla was confirmed and the air from the bulla was aspirated slowly to allow collapse. Finally, some autologous blood was instilled into the bulla before the needle was withdrawn.The patient had immediate and sustained symptomatic relief with significant improvement in lung function.Bronchoscopic transbronchial decompression of emphysematous bullae can be an effective therapeutic option and warrants further investigation. KEYWORDS: Bronchoscopic lung volume reduction, emphysematous bulla, fibreoptic bronchoscopy, lung volume reduction surgery A 50-yr-old male nonsmoker, presented with incapacitating shortness of breath, cough, fever and increased expectoration of mucoid sputum for 2 weeks. The patients had been suffering from progressive shortness of breath with episodic exacerbations associated with cough, expectoration and occasional history of wheeze over the previous 15 yrs. The patient had stopped smoking 7 yrs earlier, prior to which he had smoked heavily for .20 yrs.On examination the patient was poorly nourished (body mass index 16.75 kg?m -2 ) and grossly dyspnoic (orthopnoic on supplemental oxygen and incapable of getting out of bed), with a cardiac frequency of 130 bpm and blood pressure of 120/80 mmHg. The chest was emphysematous, however, there was no clubbing, raised jugular venous pressure or pedal oedema, but the accessory muscles of inspiration were working vigorously. The chest bellow was bilaterally symmetrical with reduced expansion (¡1 cm) and obliteration of the liver dullness. Breath sounds were grossly diminished on both sides, especially so on the left base. All other systems were essentially normal on examination.The laboratory investigations revealed haemoglobin of 11.20%, total leukocyte count was 9,800 per mm 3 with neutrophils and lymphocytes consisting 77 and 20%, respectively, and an erythrocyte sedimentation rate of 62 mm. Except initial hypokalaemia (3.2 mEq?L -1 ), serum electrolytes, blood urea nitrogen, creatinine and liver-function test results were all normal. The sputum did not reveal any acid-fast bacilli on three occasions but sputum culture showed growth of Klebsiella species sensitive t...

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“…[15][16][17][18][19][20][23][24][25] Based on epidemiological data, among 100 000 men in the age group of the cases reported, one might find 116 with bullae evident on chest radiography. Cannabis smoking is common, so the two will occur together by coincidence.…”

Section: Discussionmentioning

confidence: 99%

“…The emphasis in the older reports was entirely on ridding the patient of bullae that were seen to be a waste of space. [18][19][20]24,25 The more common condition, primary spontaneous pneumothorax, is a familiar cause of attendance at accident and emergency departments and of medical admissions.…”

Section: Discussionmentioning

confidence: 99%