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 | |
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.jpg) Cross section of Bullous emphysema |
References
edit- ^ 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.
- ^ 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.
- ^ 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.
- ^ 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.
- ^ 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.
- ^ 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.