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32 patients (2 females and 32 males) with bilateral pulmonary bullose emphysema have been treated in Acad.. Z. Tskhakaia Thoracoabodminal clinic from 1998 through 2004. Age varied from 17 to 64 years. In 4 cases diffused emphysema observed, 17 patients were presented with gigantic bullas varied in size from 120 to 150 mm with most of them located in the upper lobes. All patients underwent preoperative full range radiology study including CT scan, in 17 cases an additional gamascintygraphy was utilized. 19 patients underwent lung preserving bilateral resection through transsternal approach. In 6 cases surgery was performed by bilateral video assisted mini thoracotomy route. In 7 cases bilateral operation was performed by thoracotomy on one side and thoracoscopy on another. In this series neither morbidity nor mortality was observed.
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