Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study.
Giant pulmonary bullae (GPB) are rare and there is little information on incidence, long-term prognosis, and outcome of treatment. To assess the incidence of GPB in the Icelandic population and to evaluate the outcome of surgical treatment. Twelve consecutive patients (11 males; mean age 60 ± 15.7 y...
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ftlandspitaliuni:oai:www.hirsla.lsh.is:2336/299083 2023-05-15T16:47:43+02:00 Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. Gunnarsson, S I Johannesson, K B Gudjonsdottir, M Magnusson, B Jonsson, S Gudbjartsson, T Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. 2013-07-19 http://hdl.handle.net/2336/299083 en eng Scand J Surg 2012, 101(3):166-9 1457-4969 22968239 http://hdl.handle.net/2336/299083 Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society Archived with thanks to Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society Closed - Lokað Adult Aged Blister Female Follow-Up Studies Humans Iceland Incidence Kaplan-Meier Estimate Lung Diseases Male Middle Aged Pneumonectomy Postoperative Complications Pulmonary Emphysema Registries Respiratory Function Tests Retrospective Studies Smoking Survival Rate Treatment Outcome Article 2013 ftlandspitaliuni 2022-05-29T08:21:51Z Giant pulmonary bullae (GPB) are rare and there is little information on incidence, long-term prognosis, and outcome of treatment. To assess the incidence of GPB in the Icelandic population and to evaluate the outcome of surgical treatment. Twelve consecutive patients (11 males; mean age 60 ± 15.7 years) underwent resection for GPB in Iceland between 1992 and 2009. All were heavy smokers and had bullae occupying > 30% of the involved lung. There were 8 bilateral and 3 unilateral bullectomies and one lobectomy. Pulmonary function tests were performed preoperatively, and at one month and 5.4 years postoperatively. Age-standardized incidence rate (ASR) was calculated, complications and operative mortality were registered, and overall survival was estimated. Mean follow-up time was 8.2 years. The ASR for GPB was 0.40 and 0.03 per 100,000 per year for men and women, respectively. There was no operative mortality, but prolonged air leakage (75%) and pneumonia (17%) were the most common postoperative complications. One month postoperatively, mean FEV1 increased from 1.0 ± 0.48 L (33% predicted) to 1.75 ± 0.75 L (57.5% predicted) (p < 0.01), but FVC remained unchanged. RV decreased from 3.9 ± 0.8 L (177% predicted) to 3.0 ± 1.0 L (128% predicted) (p < 0.05), but TLC and DLCO did not change after operation. At long-term follow-up the FEV1 and FVC had declined to near-baseline values. Five-year and 10-year survival were 100% and 60%, respectively. The ASR of GPB in Iceland was 0.21 per 100,000 per year. In this small series, bullectomy was found to be a safe procedure that significantly improved pulmonary function. The functional improvement then declined over time. Prolonged air leakage was a common postoperative complication that prolonged hospital stay. Article in Journal/Newspaper Iceland Hirsla - Landspítali University Hospital research archive Meier ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
institution |
Open Polar |
collection |
Hirsla - Landspítali University Hospital research archive |
op_collection_id |
ftlandspitaliuni |
language |
English |
topic |
Adult Aged Blister Female Follow-Up Studies Humans Iceland Incidence Kaplan-Meier Estimate Lung Diseases Male Middle Aged Pneumonectomy Postoperative Complications Pulmonary Emphysema Registries Respiratory Function Tests Retrospective Studies Smoking Survival Rate Treatment Outcome |
spellingShingle |
Adult Aged Blister Female Follow-Up Studies Humans Iceland Incidence Kaplan-Meier Estimate Lung Diseases Male Middle Aged Pneumonectomy Postoperative Complications Pulmonary Emphysema Registries Respiratory Function Tests Retrospective Studies Smoking Survival Rate Treatment Outcome Gunnarsson, S I Johannesson, K B Gudjonsdottir, M Magnusson, B Jonsson, S Gudbjartsson, T Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
topic_facet |
Adult Aged Blister Female Follow-Up Studies Humans Iceland Incidence Kaplan-Meier Estimate Lung Diseases Male Middle Aged Pneumonectomy Postoperative Complications Pulmonary Emphysema Registries Respiratory Function Tests Retrospective Studies Smoking Survival Rate Treatment Outcome |
description |
Giant pulmonary bullae (GPB) are rare and there is little information on incidence, long-term prognosis, and outcome of treatment. To assess the incidence of GPB in the Icelandic population and to evaluate the outcome of surgical treatment. Twelve consecutive patients (11 males; mean age 60 ± 15.7 years) underwent resection for GPB in Iceland between 1992 and 2009. All were heavy smokers and had bullae occupying > 30% of the involved lung. There were 8 bilateral and 3 unilateral bullectomies and one lobectomy. Pulmonary function tests were performed preoperatively, and at one month and 5.4 years postoperatively. Age-standardized incidence rate (ASR) was calculated, complications and operative mortality were registered, and overall survival was estimated. Mean follow-up time was 8.2 years. The ASR for GPB was 0.40 and 0.03 per 100,000 per year for men and women, respectively. There was no operative mortality, but prolonged air leakage (75%) and pneumonia (17%) were the most common postoperative complications. One month postoperatively, mean FEV1 increased from 1.0 ± 0.48 L (33% predicted) to 1.75 ± 0.75 L (57.5% predicted) (p < 0.01), but FVC remained unchanged. RV decreased from 3.9 ± 0.8 L (177% predicted) to 3.0 ± 1.0 L (128% predicted) (p < 0.05), but TLC and DLCO did not change after operation. At long-term follow-up the FEV1 and FVC had declined to near-baseline values. Five-year and 10-year survival were 100% and 60%, respectively. The ASR of GPB in Iceland was 0.21 per 100,000 per year. In this small series, bullectomy was found to be a safe procedure that significantly improved pulmonary function. The functional improvement then declined over time. Prolonged air leakage was a common postoperative complication that prolonged hospital stay. |
author2 |
Department of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland. |
format |
Article in Journal/Newspaper |
author |
Gunnarsson, S I Johannesson, K B Gudjonsdottir, M Magnusson, B Jonsson, S Gudbjartsson, T |
author_facet |
Gunnarsson, S I Johannesson, K B Gudjonsdottir, M Magnusson, B Jonsson, S Gudbjartsson, T |
author_sort |
Gunnarsson, S I |
title |
Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
title_short |
Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
title_full |
Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
title_fullStr |
Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
title_full_unstemmed |
Incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
title_sort |
incidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study. |
publishDate |
2013 |
url |
http://hdl.handle.net/2336/299083 |
long_lat |
ENVELOPE(-45.900,-45.900,-60.633,-60.633) |
geographic |
Meier |
geographic_facet |
Meier |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
Scand J Surg 2012, 101(3):166-9 1457-4969 22968239 http://hdl.handle.net/2336/299083 Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society |
op_rights |
Archived with thanks to Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Society Closed - Lokað |
_version_ |
1766037812264566784 |