Bilateral thoracoscopic stapled volume reduction for bullous vs diffuse emphysema.
BACKGROUND
We compared our results with bullous vs diffuse emphysema by performing a bilateral thoracoscopic stapled volume reduction technique in 15 patients (age 45-80, 10 males, five females).


METHODS
Eight patients demonstrated bullous emphysema and seven patients diffuse emphysema. Lung reduction was performed with a bilateral thoracoscopic stapled technique utilizing bovine pericardium in the supine position.


RESULTS
Comparison of the bullous versus diffuse groups revealed no significant differences in means for the following variables: length of air leak (7.5 vs 3.3 days); length of stay (8.1 vs 6.5 days); pre-op FEV1, (23% vs 22%); pre-op dyspnea index (3.4 vs 3.6). At 3 months the bullous subset had a highly significant improvement (p < 0.007) in FEV1 (88%) compared with the diffuse subset FEV1 (59%).


CONCLUSIONS
These early results suggest that patients with bullous emphysema are at no greater risk and demonstrate a significantly greater improvement in FEV1 than patients with diffuse emphysema.
Champion
J K
JK
Dunwoody Medical Center, Atlanta, GA 30338, USA.
McKernan
J B
JB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004724:Endoscopy; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000379:methods*; D011656:Pulmonary Emphysema / Q000503:physiopathology / Q000601:surgery*; D013906:Thoracoscopy