Bullectomy for COPD - Topic Overview
Chronic obstructive pulmonary disease (COPD) weakens
the structure of the lung and may also damage the tiny air sacs (alveoli) in
the lung. When these air sacs break down, larger airspaces known as bullae are
Bullae sometimes can become so large that they interfere with
breathing and may cause complications:
- They can burst, leading to a collapsed lung
(pneumothorax). A collapsed lung will often need
treatment with a chest tube.
- They can become infected, leading to
abscess in the lung that can spread to the
pleural cavity (the space between the lung and the membrane that surrounds it).
This condition (empyema) can be difficult to resolve and often requires
extensive treatment with antibiotics.
For some people, surgically removing the enlarged air sacs—known as
a bullectomy—makes breathing easier. But few people are considered good
candidates for a bullectomy. It may work best for people with COPD who are
young, have large bullae that are grouped in just one area of the lung, and do
not have severe blockage in their airways. A
bullectomy may be considered if the bullae:
- Are larger than one-third of a
- Prevent the lung from expanding so the person cannot move
enough air into his or her lungs.
Bullectomy may make the lungs work better so more oxygen gets into
If there are many bullae spread throughout the lungs, surgery is not
likely to be helpful. In this case, other areas of the lung often become
damaged after the surgery. The best surgical results happen when there is
only one bulla or only a few that are all clustered in one area.
Long-term follow-up studies have begun to show that within 3 to 5
years after surgery, lung function deteriorates to the level it was before
The decision about whether to do the surgery is difficult and
usually is based on the doctor's experience and the person's overall
Bullae can be removed using a laser. But this method has not been
found to have an advantage over traditional surgery.