Are superficial bullae with broad bases suitable for ablation?

  • Noriyoshi Sawabata
  • Akihide Matsumura
  • Masahito Ikeda
  • Satoru Nanjo
  • Keiji Iuchi
  • Takashi Mori
Original Article


Superficial bullae with broad bases are not suitable for resection, because the residual lung is too deformed to re-expand adequately when we resect them. Therefore, we believe superficical bullae with broad bases are suitable for ablation. It is not clear, however, whether ablated superficical bullae with broad bases remain contracted after treatment or not We examined the morphologic changes of ablated superficical bullae with broad bases on chest computed tomographs. Ten patients with superficical bullae with broad bases that could be identified on computed tomograph underwent ablation using an electrocoagulator. These bullae were examined by chest computed tomograph preoperatively and again one, three and 12 months after surgery. There were no intra-operative complications. Postoperatively, the only complication was prolonged air leak (more than 7 days) in 1 (10%) patient Pneumothorax after the operation presented in 1 (10%) patient Morphologically, a disappearance of air space associated with bulla-wall thickness was observed in 9 (90%) of the 10 heat-ablated lesions and air space decreased in 1 (10%) lesion. Heat ablation proved to be effective in patients with SBBs. Lesions remained contracted for at least one year after the operation.

Index words

bullae ablation chest computed tomography 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Wakabayashi A. Thoracoscopic ablation of blebs in the treatment of recurrent or persistent spontaneous pneumothorax. Ann Thorac Surg 1989; 48: 651–3.PubMedCrossRefGoogle Scholar
  2. 2.
    Wakabayashi A, Brenner M, Wilson AF, Tadir Y, Berns M. Thoracoscopic treatment of spontaneous pneumothorax using carbon dioxide laser. Ann Thorac Surg 1990; 50: 786–90.PubMedGoogle Scholar
  3. 3.
    Torre M, Belloni P. Nd: YAG laser pleurodesis through thoracoscopy: new curative therapy in spontaneous pneumothorax. Ann Thorac Surg 1989; 47: 887–9.PubMedCrossRefGoogle Scholar
  4. 4.
    Rusch VW, Schmidt R, Shoji Y, Fujimura Y. Use of the argon beam electrocoagulator for performing pulmonary wedge resections. Ann Thorac Surg 1990; 49: 287–91.PubMedCrossRefGoogle Scholar
  5. 5.
    DeVries WC, Wolfe WG. The management of spontaneous pneumothorax and bullous emphysema. Surg Clin North Am 1980; 60: 851–6.PubMedGoogle Scholar
  6. 6.
    Sawabata N, Iuchi K, Ikeda M, Sueki H, Mori T. Safe pleural contraction employing a new tip for electro surgical units-An ex vivo experiment-. JJTCVS 1998; 46: 1221–5.Google Scholar
  7. 7.
    Goldberg M, Pearson FG. Emphysema and bullous disease. 1st ed. Thoracic surgery. New York: Churchill Livingstone, 1995: 561–80.Google Scholar
  8. 8.
    Sawabata N, Nezu K, Tojo T, Kitamura S. In vitro study of ablated lung tissue in Nd: YAG laser irradiation. Ann Thorac Surg 1996; 61: 164–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Sawabata N, Nezu K, Tojo T, Kitamura S. In vitro comparison between Argon Beam Coagulator and Nd: YAG laser in lung contraction therapy. Ann Thorac Surg 1996; 62: 1485–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Sawabata N, Nezu K, Tojo T, Kawachi K, Kitamura S. Morphologic examination of the lung tissue ablated with Nd; YAG laser for the treatment of bullous pulmonary disease. (in Japanese with English abstract) J Jpn Assn Thorac Surg 1995; 43: 831–5.Google Scholar
  11. 11.
    McKenna RJ, Brenner M, Fischel RJ, Gelb AF. A randomized prospective trial of stapled lung reduction versus laser bullectomy for diffuse emphysema. J Thorac Cardiovasc Surg 1996; 111: 317–22.PubMedCrossRefGoogle Scholar

Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 1999

Authors and Affiliations

  • Noriyoshi Sawabata
    • 1
  • Akihide Matsumura
    • 2
  • Masahito Ikeda
    • 3
  • Satoru Nanjo
    • 4
  • Keiji Iuchi
    • 2
  • Takashi Mori
    • 2
  1. 1.Division of SurgeryToneyama National HospitalOsakaJapan
  2. 2.Division of SurgeryNational Kinki Chuoh Hospital for Chest DiseasesOsakaJapan
  3. 3.Division of SurgeryOhtemae HospitalOsakaJapan
  4. 4.Division of SurgeryAonogahara National HospitalHyogoJapan

Personalised recommendations