Novel method of thoracoscopic surgery for giant bulla without residual cavity.
A giant bulla is generally resected by thoracoscopic surgery. Resection using an automated stapling device is popular, however, a number of cartridges may be consumed and a cavity is sometimes left remaining, especially when resecting wide-based lesions. To establish a thoracoscopic surgical procedure that results in no residual cavity, we developed a method in which the roof of the bulla is resected first, followed by resection of the pulmonary parenchyma, including the base of the bulla, using a stapling device. Exposure of the base by first removing the roof facilitates determination of the resection line. Between 2003 and 2005, the procedure was attempted in 6 patients, which included one bilateral case. Conversion to a minithoracotomy was required in one patient because of bulla thickening. The operating time ranged from 80 to 150 min (median, 135 min) in the other 6 cases. Postoperative chest drainage ranged from 2 to 13 days (median, 3 days), and postoperative hospital stay was 5 to 18 days (median, 6 days). No adverse events occurred. We found this procedure to be simple and useful for complete resection of giant bullae.
Department of General Thoracic Surgery, Takarazuka Municipal Hospital, Hyogo, Japan. utsumi@surg1.med.osaka-u.ac.jp
Tomoki
T
Utsumi
Akinori
A
Akashi
Soichiro
S
Funaki
D000328:Adult; D001768:Blister / Q000473:pathology / Q000601:surgery*; D004322:Drainage; D006801:Humans; D007902:Length of Stay; D008171:Lung Diseases / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013528:Surgical Staplers; D013906:Thoracoscopy / Q000009:adverse effects / Q000379:methods*; D013908:Thoracotomy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome