Abstract

CHENG HUNG, Kai et al. Morbidity and mortality in the surgery of emphysematous bullae. Rev Cubana Cir [online]. 2008, vol.47, n.1, pp. 0-0. ISSN 1561-2945.

INTRODUCTION. The thirsty for air is the most unbearable of all the human appetites and probably no anguish can be compared with that occasioned by the impossibility of breathing adequately. The aim of this paper was to study the pulmonary bullous disease treated with surgery, according to the working algorithm created at "Comandante Manuel Fajardo" Hospital. METHODS. 36 patients operated on from 1995 to 2004 were prospectively studied. To clinically determine the state of the patients in the preoperative and postoperative, it was used the dyspnea index recommended by the American Thorax Society. Surgical risk was assessed according to the classification of the American Society of Anesthesia and the Goldman's index for cardiac risk in non-cardiac surgery. RESULTS. The main indications of the surgical treatment in the patients with emphysematous bullae were the giant bullae and the bullous pneumothorax (92 %). The morbidity of surgical interventions was very high (61.1 %). Most of them were not important. The air leak was the most frequent of the complications (22.2 %), followed by seroma of the surgical wound (11.1 %). Mortality was low (2.8 %), with only one dead due to an acute respiratory failure. CONCLUSIONS. Bullectomy with atypical resection is the preferred surgical technique to preserve the greatest amount of functional pulmonary tissue. The dyspnea index showed a remarkable improvement between the pre- and postoperative evaluations of the pulmonary function. We considered that this indicator is higher than the forced expiratory volume in the first second (FEV1) for the assessment of surgery effectivity and that it is also an excellent marker of the improvement of the quality of life of the patients

Keywords : Emphytematous bullae; morbidity; mortality; dyspnea index.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )