CTSN - Bullous Emphysema and Pneumothorax References

Bullous Emphysema and Pneumothorax References Selected References
Selected Articles
Cooper JD, Trulock EP, Triantafillou AN, Patterson GA, Pohl MS, Deloney PA, Sundaresan RS, Roper CL. Bilateral pneumectomy (volume reduction) for chronic obstructive pulmonary disease. Journal of Thoracic and Cardiovascular Surgery 1995 109(1):106-19.

This series of 20 patients has a mean follow-up of 6 months. Patients had significant improvement in FEV1, exercise tolerance, and quality of life.

McKenna RJ Jr, Brenner M, Gelb AF, Mullin M, Singh N, Peters H, Panzera J, Calmese J, Schein MJ. A randomized, prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema. Journal of Thoracic and Cardiovascular Surgery 1996 111(2):317-21.

Seventy-two patients were randomized in this trial; there was no difference in length of stay or air leak. However, patients in the staple group had a significantly greater improvement in FEV1 at 6 months.

Klingman RR, Angelillo VA, DeMeester TR. Cystic and bullous lung disease. Annals of Thoracic Surgery 1991 52(3):576-80.

This short article has several representative chest films and provides instruction on how to select patients who will benefit from surgical intervention.

Cole FH Jr, Cole FH, Khandekar A, Maxwell JM, Pate JW, Walker WA. Video-assisted thoracic surgery: Primary therapy for spontaneous pneumothorax? Annals of Thoracic Surgery 1995 60(4):931-3.

The authors compare 30 patients treated with VATS pleural abrasion to 89 patients treated conventionally. Conclusions: there is no advantage of VATS over initial tube thoracostomy or over conventional thoracotomy.

Bertrand PC, Regnard JF, Spaggiari L, Levi JF, Magdeleinat P, Guibert L, Levasseur P. Immediate and long-term results after surgical treatment of primary spontaneous pneumothorax by VATS. Annals of Thoracic Surgery 1996 61(6):1641-5.

These authors' series of 163 patients were compared to 87 patients treated with limited thoracotomy. Conclusion: VATS will probably become the treatment of choice for spontaneous pneumothorax.

Sources for further reading
Textbook Chapters
Chapter 16: The Pleura; Chapter 24: Congenital Lesions of the Lung and Emphysema. Surgery of the Chest (Sabiston and Spencer), 5th ed., 445-54, 801-9.

Chapter 14: Surgical Treatment of Bullous Emphysema; Chapter 30: Benign and Malignant Disorders of the Pleura. Glenn's Thoracic and Cardiovascular Surgery (Baue, Geha, Hammond, Laks, and Naunheim), 6th ed., 247-58, 537-56.

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