Results of the surgical treatment of pulmonary bleb and bullous disease

Abstract

Objective: Bullous lung disease is characterised by the development of bullae within the lung parenchyma. Smoking is considered as a main risk factor of bullae formation. The clinical manifestation varies from asymptomatic bullae to severe respiratory distress. The exact medical approach is still controversial. Here, we aimed to evaluate the patient clinical characteristics and the indication of surgery in the patients. Methods: This study was an analytic cross-sectional study in Razi hospital, Rasht, Iran, in 2016–2020. A total of 110 patients with newly diagnosed lung bullae underwent evaluation based on a checklist, which assessed the variables as clinical characteristics, bullae features, the medical treatment, and its complication. Eventually, statistical analysis was performed by using SPSS v21.0. Results: A total of 110 patients were enrolled. All the patients were smokers. In 72.9%, the primary presentation was respiratory distress, which needed surgical resection with no recurrence over 8 months. The clinical manifestation varies from asymptomatic bullae in 4.3% and pneumonia in 34.3% to respiratory distress in 61.4%. There was no statistical correlation between clinical manifestation and all the studied variables excluding respiratory distress (p value: 0.659). Seventy patients underwent surgical treatment, in which 20 cases were complicated by air leak that was managed by the chest tube in 16 patients and the Heimlich valve in four patients. No evidence of recurrence was detected. Conclusion: The main risk factor of bulla formation is smoking. Because of various clinical presentations, the appropriate medical approach is of paramount importance.

Bullous Lung Disease (BLD): A Narrative Literature Review

“…resulting in distension of the air space due to delayed emptying. 11 Environmental factors such as smoking and exposure to dust are additional risk factors and are associated with a rapid deterioration in the patient's condition. Patient factors such as genetics and age also influence the development of the disease, and a link has been found between smoking and α1-antitrypsin deficiency, resulting in the formation of BLD.…”

“…Surgical management of damaged lung areas using the LVRS method (lung volume reduction surgery) can improve the quality of life of patients, but in recent years, BLVR (Bronchoscopy lung volume reduction) has become an alternative and promising treatment in the management of BLD-type severe. [9][10][11]…”