Surgical improvement of patients with pulmonary insufficiency due to localized bullous emphysema or giant cysts.

Patients with continuous expansion of either giant lung cysts or areas of localized bullous emphysema will eventually deteriorate into a state of extreme respiratory distress due to compression of the remaining healthy pulmonary tissue. Thirty-one patients with these 2 types of lung disease having very poor respiratory function underwent surgery for the release of compromised healthy lung by resection of the expanding processes. A rational investigation program including respiratory tests, ventilation and perfusion scintigraphy and pulmonary angiography was gradually developed and analyzed. Surgical mortality was 12.9% in unilateral operations, probably somewhat higher in later contralateral interventions. The operative risk was higher in the emphysema group than in the group with giant lung cysts. Follow-up has demonstrated encouraging results in both groups concerning increased pulmonary function as well as improved working capacity.