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dc.contributor.authorGunnarsson, S I
dc.contributor.authorJohannesson, K B
dc.contributor.authorGudjonsdottir, M
dc.contributor.authorMagnusson, B
dc.contributor.authorJonsson, S
dc.contributor.authorGudbjartsson, T
dc.date.accessioned2013-08-19T12:00:43Z
dc.date.available2013-08-19T12:00:43Z
dc.date.issued2012
dc.date.submitted2013-07-19
dc.identifier.citationScand J Surg 2012, 101(3):166-9en_GB
dc.identifier.issn1457-4969
dc.identifier.pmid22968239
dc.identifier.urihttp://hdl.handle.net/2336/299083
dc.description.abstractGiant 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.
dc.language.isoenen
dc.rightsArchived with thanks to Scandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Societyen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlisteren_GB
dc.subject.meshFemaleen_GB
dc.subject.meshFollow-Up Studiesen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIcelanden_GB
dc.subject.meshIncidenceen_GB
dc.subject.meshKaplan-Meier Estimateen_GB
dc.subject.meshLung Diseasesen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshPneumonectomyen_GB
dc.subject.meshPostoperative Complicationsen_GB
dc.subject.meshPulmonary Emphysemaen_GB
dc.subject.meshRegistriesen_GB
dc.subject.meshRespiratory Function Testsen_GB
dc.subject.meshRetrospective Studiesen_GB
dc.subject.meshSmokingen_GB
dc.subject.meshSurvival Rateen_GB
dc.subject.meshTreatment Outcomeen_GB
dc.titleIncidence and outcomes of surgical resection for giant pulmonary bullae--a population-based study.en
dc.typeArticleen
dc.contributor.departmentDepartment of Cardiothoracic Surgery, Landspitali University Hospital, Reykjavik, Iceland.en_GB
dc.identifier.journalScandinavian journal of surgery : SJS : official organ for the Finnish Surgical Society and the Scandinavian Surgical Societyen_GB
dc.rights.accessClosed - Lokaðen
html.description.abstractGiant 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.


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