Surgical management of emphysema

E. A. Gaensler, D. W. Cugell, R. J. Knudson, M. X. FitzGerald

Research output: Contribution to journalReview articlepeer-review

75 Scopus citations

Abstract

The history of surgery of the treatment of emphysema and its complications is long and complex and, with improved understanding of the pathophysiology, most procedures have been discarded. Present clear indications for surgery are mainly large or increasing bullae that results in compression of apparently good lung tissue, and complications of bullous emphysema such as pneumothorax and infection. With localized giant bullae the results of local resection can be as dramatic as the effects of pleural drainage for tension pneumothorax. Lobectomy should not be undertaken until bullae have been removed locally and application of positive pressure has failed to reveal any expandable lung tissue - a rare situation. Resection of small bullae generally has no effect on lung function. The indications for resection of large bullae in the presence of diffuse emphysema require careful individual study. In such cases even a small increment of function may be of great clinical benefit, and there is evidence that longevity can be increased. Finally, two-stage local drainage of tension bullae may be indicated in those rare cases in which open thoracotomy cannot be considered for other reasons.

Original languageEnglish (US)
Pages (from-to)443-463
Number of pages21
JournalClinics in Chest Medicine
Volume4
Issue number3
StatePublished - 1983

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

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