Biomaterial Database

[Open thoracic surgery of giant bullous pulmonary emphysema in adults]. 1995

M Ribet, and K Ghoch

Clinique Chirurgicale Ouest, Hôpital Calmette, CHU, Lille.

Ninety-two adult patients underwent open surgery for unilateral (60) or bilateral (32) emphysematous bullae filling at least one third of an hemithorax: 56 were apical, 34 were basal and 2 were apical on one side and basal on the other side. A first group of 18 patients were admitted in critical care medicine, after an acute complication, in a state of respiratory distress which was not controlled by oxygen therapy and/or drainage, 17 of them being mechanically ventilated at time of operation. In this group 9 patients died, 8 of them with bilateral bullae and 5 with cor pulmonale. A second group of 74 patients underwent surgery after a delay during which symptoms appeared or worsened, complications were observed or a radiological opacity was discovered. In this group 5 patients died. During a mean 4.8 year follow-up, 55 patients among the 71 survivors with no associated cancer were in a better functional state and remained clinically stable. The patients history and the results of surgery suggest that: 1) giant bullae should be resected when they increase in volume, when they are bilateral and when symptoms progress; 2) criteria for surgery are not limited to patients having compression of lower lobes from apical bullae; 3) it is necessary to operate on both sides for bilateral disease in elective surgery; 4) when there is a state of respiratory distress after a complication of bilateral bullae, the mortality is prohibitive; 5) cor pulmonale is of poor prognosis; 6) diffuse lung disease and associated diseases add to mortality and morbidity.(ABSTRACT TRUNCATED AT 250 WORDS)

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D010166	Palliative Care	Care alleviating symptoms without curing the underlying disease. (Stedman, 25th ed)	Palliative Treatment,Palliative Supportive Care,Palliative Surgery,Palliative Therapy,Surgery, Palliative,Therapy, Palliative,Care, Palliative,Palliative Treatments,Supportive Care, Palliative,Treatment, Palliative,Treatments, Palliative
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D011656	Pulmonary Emphysema	Enlargement of air spaces distal to the TERMINAL BRONCHIOLES where gas-exchange normally takes place. This is usually due to destruction of the alveolar wall. Pulmonary emphysema can be classified by the location and distribution of the lesions.	Emphysema, Pulmonary,Centriacinar Emphysema,Centrilobular Emphysema,Emphysemas, Pulmonary,Focal Emphysema,Panacinar Emphysema,Panlobular Emphysema,Pulmonary Emphysemas,Centriacinar Emphysemas,Centrilobular Emphysemas,Emphysema, Centriacinar,Emphysema, Centrilobular,Emphysema, Focal,Emphysema, Panacinar,Emphysema, Panlobular,Emphysemas, Centriacinar,Emphysemas, Centrilobular,Emphysemas, Focal,Emphysemas, Panacinar,Emphysemas, Panlobular,Focal Emphysemas,Panacinar Emphysemas,Panlobular Emphysemas
D011660	Pulmonary Heart Disease	Hypertrophy and dilation of the RIGHT VENTRICLE of the heart that is caused by PULMONARY HYPERTENSION. This condition is often associated with pulmonary parenchymal or vascular diseases, such as CHRONIC OBSTRUCTIVE PULMONARY DISEASE and PULMONARY EMBOLISM.	Cor Pulmonale,Disease, Pulmonary Heart,Diseases, Pulmonary Heart,Heart Disease, Pulmonary,Heart Diseases, Pulmonary,Pulmonary Heart Diseases
D012121	Respiration, Artificial	Any method of artificial breathing that employs mechanical or non-mechanical means to force the air into and out of the lungs. Artificial respiration or ventilation is used in individuals who have stopped breathing or have RESPIRATORY INSUFFICIENCY to increase their intake of oxygen (O2) and excretion of carbon dioxide (CO2).	Ventilation, Mechanical,Mechanical Ventilation,Artificial Respiration,Artificial Respirations,Mechanical Ventilations,Respirations, Artificial,Ventilations, Mechanical
D012128	Respiratory Distress Syndrome	A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA.	ARDS, Human,Acute Respiratory Distress Syndrome,Adult Respiratory Distress Syndrome,Pediatric Respiratory Distress Syndrome,Respiratory Distress Syndrome, Acute,Respiratory Distress Syndrome, Adult,Respiratory Distress Syndrome, Pediatric,Shock Lung,Distress Syndrome, Respiratory,Distress Syndromes, Respiratory,Human ARDS,Lung, Shock,Respiratory Distress Syndromes,Syndrome, Respiratory Distress
D001768	Blister	Visible accumulations of fluid within or beneath the epidermis.	Bulla,Vesication,Bleb,Bullae,Bullous Lesion,Blebs,Blisters,Bullous Lesions,Lesion, Bullous,Lesions, Bullous,Vesications
D002908	Chronic Disease	Diseases which have one or more of the following characteristics: they are permanent, leave residual disability, are caused by nonreversible pathological alteration, require special training of the patient for rehabilitation, or may be expected to require a long period of supervision, observation, or care (Dictionary of Health Services Management, 2d ed). For epidemiological studies chronic disease often includes HEART DISEASES; STROKE; CANCER; and diabetes (DIABETES MELLITUS, TYPE 2).	Chronic Condition,Chronic Illness,Chronically Ill,Chronic Conditions,Chronic Diseases,Chronic Illnesses,Condition, Chronic,Disease, Chronic,Illness, Chronic