Bullectomy

Bullectomy is a surgical procedure in which dilated air-spaces or bullae in lung parenchyma are removed.[1] Common causes of dilated air-spaces include chronic obstructive pulmonary disease and emphysema. Patients with giant bullae filling half the thoracic volume and compressing relatively normal adjacent parenchyma are recommended for bullectomy.[2][3] It is also indicated in severe dyspnea, repeated respiratory infections and spontaneous pneumothorax.[4] The size of dilated air-spaces or bullae volume is the most important factor in relation to ventilator capacity post-bullectomy. In cases where the size of bullae are enlarged, bullectomy is indicated if the percentage of forced expiratory volume in one second(FEV1%) is greater than 40% and the regional ventilation over volume dynamic(V/V Dynamic) is greater than 0.5.[5][6]

Bullectomy
Cross section of Bullous emphysema

References

  1. Petro, W.; Hübner, C.; Greschuchna, D.; Maassen, W.; Konietzko, N. (1 December 1983). "Bullectomy". The Thoracic and Cardiovascular Surgeon. 31 (6): 342–345. doi:10.1055/s-2007-1022015. PMID 6198753.
  2. Meyers BF, Patterson GA (July 2003). "Chronic obstructive pulmonary disease. 10: Bullectomy, lung volume reduction surgery, and transplantation for patients with chronic obstructive pulmonary disease". Thorax. 58 (7): 634–8. doi:10.1136/thorax.58.7.634. PMC 1746734. PMID 12832685.
  3. De Giacomo T, Rendina EA, Venuta F, Moretti M, Mercadante E, Mohsen I, Filice MJ, Coloni GF (September 2002). "Bullectomy is comparable to lung volume reduction in patients with end-stage emphysema". European Journal of Cardio-Thoracic Surgery. 22 (3): 357–62. doi:10.1016/s1010-7940(02)00351-2. PMID 12204723.
  4. Chung PH, Wong KK, Lan LC, Tam PK (September 2009). "Thoracoscopic bullectomy for primary spontaneous pneumothorax in pediatric patients". Pediatric Surgery International. 25 (9): 763–6. doi:10.1007/s00383-009-2432-9. PMID 19652983.
  5. Baldi S, Palla A, Mussi A, Falaschi F, Carrozzi L, Giuntini C, Angeletti CA (1 July 2001). "Influence of bulla volume on postbullectomy outcome" (PDF). Canadian Respiratory Journal. 8 (4): 233–8. doi:10.1155/2001/479653. PMID 11521138.
  6. Nakahara K, Nakaoka K, Ohno K, Monden Y, Maeda M, Masaoka A, Sawamura K, Kawashima Y (May 1983). "Functional indications for bullectomy of giant bulla". The Annals of Thoracic Surgery. 35 (5): 480–7. doi:10.1016/s0003-4975(10)60419-5. PMID 6847283.
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