HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Wakabayashi, A. Search for Related Content PubMed PubMed Citation Articles by Wakabayashi, A.

The Annals of Thoracic Surgery, Vol 56, 708-712, Copyright © 1993 by The Society of Thoracic Surgeons

ARTICLES

Thoracoscopic technique for management of giant bullous lung disease

A Wakabayashi
Department of Surgery, University of California, Irvine.

Giant bullae of the lungs are readily recognizable on plain chest x-ray films and are rare. Only 17 of more than 500 cases of thoracoscopic treatment of bullous lung disease over the past 3 years involved giant bullae, which included both types 1 and 4. Type 1 bullae have smooth internal lining without trabeculae and type 4 have trabeculae. The indications were dyspnea in 10 cases, spontaneous pneumothorax in 6, and infection in 1. The mean age of the patients was 55 years. Five patients were oxygen dependent, 1 was wheelchair-bound, and 3 were steroid dependent. Preoperative spirometry was available in 1 patient with type 1 bullae (forced vital capacity = 95% and forced expiratory volume in 1 second = 55% of the predicted values) and in 10 patients with type 4 bullae (forced vital capacity = 46.90% +/- 15.29% and forced expiratory volume in 1 second = 23.50% +/- 7.46% of the predicted values). Under general anesthesia with one-lung ventilation, the giant bullae were excised, plicated, or contracted by the laser, depending on the type, by means of thoracoscopy. Thoracoscopic surgery was successful in all patients, and no procedure was converted to thoracotomy. The duration of anesthesia was 4.44 +/- 1.49 hours, postoperative ventilatory support 42.24 +/- 64.22 hours, and postoperative air leaks 14.59 +/- 14.11 days. All patients did very well and pain was minimal. There was no recurrence for up to 3 years of follow-up. In conclusion, thoracoscopic treatment of giant bullae of the lungs is an effective alternative to conventional thoracotomy with minimal morbidity.

This article has been cited by other articles:

				D. Divisi, C. Battaglia, W. Di Francescantonio, G. Torresini, and R. Crisci Giant bullous emphysema resection by VATS. Analysis of laser and stapler techniques Eur. J. Cardiothorac. Surg., December 1, 2002; 22(6): 990 - 994. [Abstract] [Full Text] [PDF]

				G. F. Menconi, F. M. A. Melfi, A. Mussi, A. Palla, M. C. Ambrogi, and C. A. Angeletti Treatment by VATS of giant bullous emphysema: results Eur. J. Cardiothorac. Surg., January 1, 1998; 13(1): 66 - 70. [Abstract] [Full Text] [PDF]

				N. Sawabata, K. Nezu, T. Tojo, and S. Kitamura In Vitro Comparison Between Argon Beam Coagulator and Nd:YAG Laser in Lung Contraction Therapy Ann. Thorac. Surg., November 1, 1996; 62(5): 1485 - 1488. [Abstract] [Full Text]

				M. J. Krasna, S. Deshmukh, and J. S. McLaughlin Complications of Thoracoscopy Ann. Thorac. Surg., April 1, 1996; 61(4): 1066 - 1069. [Abstract] [Full Text]

				N. Sawabata, K. Nezu, T. Tojo, and S. Kitamura In Vitro Study of Ablated Lung Tissue in Nd:YAG Laser Irradiation Ann. Thorac. Surg., January 1, 1996; 61(1): 164 - 169. [Abstract] [Full Text]

				D. E. Maziak and M. F. McKneally Video-Assisted Thoracic Surgery Ann. Thorac. Surg., March 1, 1995; 59(3): 780 - 781. [Full Text]