Summary
The aims of this study were to investigate whether a relevant functional improvement
before and after bullectomy was achieved in cases of a localized bulla and generalized
bullous changes early and fate postoperatively and to establish clear criteria for
bullectomy. For this purpose, 21 patients with a localized bulla compressing the rest
of the lung, and 19 with generalized bullae with emphysematous changes of the remaining
lung were examined before and after (1 1/2 months and 1 1/2 years) surgery.
Comparison of the preoperative and postoperative data and the follow-up included X-ray
studies with planimetric assessment of the size of the bullae, lung function tests,
perfusion scintigrams and clinical findings. The preoperative and postoperative Statistical
values of lung volume and respiratory mechanics showed the most significant differences.
Bullectomy for a localized bulla with compression of the rest of the lung led to an
improvement in gas exchange and respiratory mechanics. This operation, however, produced
no functional improvement in cases of generalized bullous changes.
Functional and clinical success is greater, the larger and more delimited the bulla
is to be seen on X-ray, the more the healthy lung tissue is compressed, and, finally,
the less associated diseases such as chronic bronchitis are present. Indication for
bullectomy should be limited to these cases. The size of the bulla should amount to
at least 2/3 of the hemithorax, preoperative function should be elearly reduced and
the patient should be suffering from dyspnea.
Key words
Bullectomy - Lung function - Lung mechanics - Bulla size - Indication for bullectomy
