Results of bullectomy.

Bullous emphysema patients with severe dyspnea or repeated pneumothorax who demonstrate compression or crowding of relatively normal underlying lung can benefit significantly from surgical intervention. As much of the normal lung should be preserved as possible by excision only of the bullae. Buttressing of the stapled bases of the bullae may minimize postoperative air leak, allowing even simultaneous bilateral operation. Further experience and follow-up of the thoracoscopic approach to bullectomy may establish it as the approach of choice rather than thoracotomy.