Chronic obstructive pulmonary disease surgery

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editors-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Priyamvada Singh, MBBS [3]

Overview

Patients with emphysema may have big bullae ranging from 1-4 cm and may occupy 1/3rd of lung space. These bullae can cause compromise to vetilation and perfusion. Bullaectomy is the surgical removal of bullae. It is commonly done in patients with FEV1 < 50% of predicted. Bullaectomy helps in re-expansion of the lung tissue.

Surgery

  • The giant bullae (1-4 cm, giant bullae may occupy 1/3rd of lung tissue) seen in patients of emphysema can compress the surrounding lung tissues and cause compromised ventilation and blood flow to unaffected lung.
  • Bullectomy is the process of removing these bullae and can help these patients as it causes expansion of the compressed lung
  • Patients who are symptomatic and have an FEV1 of less than 50% of the predicted value have a better outcome after bullectomy.
  • Postoperative bronchopleural air leak is the major complication.

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