Operative technique of bullectomy.

The exact indications and long-term results of surgical bullectomy are still not completely clear. Patients with large-sized, compressive bullae with a normal or near-normal underlying lung parenchyma may benefit from surgical bullectomy (when carefully performed) because it relieves symptoms of dyspnea and improves exercise tolerance. By contrast, the value of surgical bullectomy in patients with diffuse, noncompressive bullous disease is less satisfactory and clear, although bilateral pneumectomy (volume reduction) has been proposed recently as an alternative to lung transplantation.