気腫性肺嚢胞症の手術適応の検討

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During a 9-year period (1981 to 1989), 18 patients with emphysematous bullae occupying more than 15% of a hemithorax were surgically treated. Their ages ranged from 31 to 61 years with a mean of 46 years. All were males. Twelve had giant bullae. Four patients complained of dyspnea, three had infection and one had contralateral spontaneous pneumothorax. Eight patients had no symptoms. Bullectomy and pneumorrhaphy were performed in 17 patients, and lobectomy in one. There were no significant postoperative complaints. Two of the four with dyspnea patients were improved and two were unchanged. In eight patients with no dyspnea, there was no significant difference between the pre and post operative % VC and % FEV <SUB>1.0</SUB>. We conclude that emphysematous bullae should be resected not only in patients with dyspnea or complications such as infection or spontaneous pneumothorax but also in asymptomatic patients with progressing bullae occupying more than one segment of the lung.
特定非営利活動法人日本呼吸器外科学会の論文