Bullectomy Explained

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]}

Notes and References

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