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Bullectomy, Lung Volume Reduction Provide Similar Benefits in End-Stage Emphysema

End-stage emphysema patients who undergo either bullectomy or lung volume reduction surgery show similar improvements in symptoms, respiratory function and exercise tolerance.

Both procedures allow emphysematous lung areas to be removed, which results in improved chest wall mechanics, ventilation/perfusion ratio and expansion. It also leads to better overall function of the residual lung.

Also, bullectomy and lung volume reduction surgery are possible alternatives to lung transplantation, which is effective but is available to a limited number of patients.

The same pathophysiological mechanism may be responsible for the respiratory improvement seen in both bullectomy and lung volume reduction patients, according to investigators, but the nature of this mechanism remains unclear.

The investigators, from the Department of Thoracic Surgery at the University of Rome "La Sapienza" in Rome, Italy, compared end-stage emphysema patients who underwent either bullectomy or lung volume reduction during a five-year period.

Twenty patients underwent bullectomy and 18 patients underwent lung volume reduction surgery. The two groups were of similar age and comparable preoperative respiratory function and severity of emphysema.

Results were recorded and compared at six and 12 months. Symptoms, respiratory function and exercise tolerance improved in both groups to similar degrees.

There were no differences in perioperative data or complication rates between the two groups.
Eur J Cardiothorac Surg 2002; 22(3): 357 "Bullectomy is comparable to lung volume reduction in patients with end-stage emphysema."

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