Dramatic improvement of respiratory condition after lobectomy for localized bullous emphysema.

A case of dramatic improvement of respiratory function after lobectomy for bullous emphysema with severe hyperinflation of the left lower lobe was reported. A 72-year-old gentleman was admitted to our hospital due to increasing dyspnea with Hugh-Johns class V. His chest X-ray and computed tomography revealed a hyperinflation of the left lower lobe. Despite medication and respiratory rehabilitation, blood gas analysis showed hypercapnia and his symptoms had been progressing. Bronchofiberscopy revealed that the left lower lobe bronchi opened on inspiration and closed on expiration. Since complete destruction of the lower lobe due to air trapping was thought to be the cause of localized hyperinflation and the compression of left upper lobe, left lower lobectomy was performed. His dyspnea immediately disappeared and the respiratory function improved dramatically. We concluded that lobectomy could be considered as one of surgical options in case of complete lobar destruction in emphysema patients.