Current Research Developments on Giant Pulmonary Bullae
Abstract
capacity. The pathological mechanisms remain incompletely understood, posing ongoing challenges for treatment. In recent years, videoassisted thoracoscopic surgery (VATS) has gradually replaced open thoracotomy as the preferred treatment due to its minimal invasiveness
and faster recovery. Surgical resection of lung tissue can improve symptoms and lung function, but it may be accompanied by complications
and recurrence risks, particularly in elderly patients or those with poor cardiopulmonary function. Additionally, respiratory interventional techniques and medical adhesives have shown promising results. However, existing treatment methods still have limitations, making the selection
of appropriate approaches critical. This article systematically explores treatment strategies for giant pulmonary bullae, integrating insights
into pathogenesis, pathophysiology, clinical manifestations, and diagnostic methods, aiming to provide new directions for future research and
clinical management.
Keywords
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[1] Zhu J, Yin W, Xiao Y, et al. Application of interventional respiratory techniques in the treatment of pulmonary bullae: an update [J].
Zhonghua jie he he hu xi za zhi 2024, 47(3): 259-64.
[2] Yousaf M N, Chan N N, Janvier A. Vanishing Lung Syndrome: An Idiopathic Bullous Emphysema Mimicking Pneumothorax [J].
Cureus, 2020, 12(8): e9596.
[3] Davies P, Bradley C. Vanishing lung syndrome: giant bullous emphysema [J]. Lancet, 2017, 390(10112): 2583.
[4] Tashtoush B, Gonzalez-ibarra F, Memarpour R, et al. Vanishing Lung Syndrome in a Patient with HIV Infection and Heavy Marijuana
Use [J]. Case Rep Pulmonol, 2014, 2014: 285208.
[5] Greenberg J A, Singhal S, Kaiser L R. Giant bullous lung disease: evaluation, selection, techniques, and outcomes [J]. Chest surgery
clinics of North America, 2003, 13(4): 631-49.
[6] Hu J W, Zhong C, Yang X Q. Thoracoscopic Treatment of Giant Pulmonary Bulla With ComplexConditions: Report of 32 Cases [J].
Chinese Journal of Minimally Invasive Surgery, 2018, 18(06): 503-4+16.
[7] Samanta R P, Agarwal S, Sengupta S. Giant Bullous Emphysema Mimicking Spontaneous Pneumothorax [J]. Cureus Journal of Medical
Science, 2022, 14(11).
[8] Aramini B, Ruggiero C, Stefani A, et al. Giant bulla or pneumothorax: How to distinguish [J]. Int J Surg Case Rep, 2019, 62: 21-3.
[9] Sharma N, Justaniah A M, Kanne J P, et al. Vanishing Lung Syndrome (Giant Bullous Emphysema): CT Findings in 7 Patients and a Literature Review [J]. Journal of Thoracic Imaging, 2009, 24(3): 227-30.
[10] Lichtenstein D, Rialp G. Lung ultrasound in a dyspneic patient with giant bullae [J]. Intensive Care Medicine, 2019, 45(5): 690-1.
[11] Zheng Z, Yuan Y, Han Z, et al. A case of chronic empyema misdiagnosed as a giant bullae emphysema [J]. Chinese Journal of Clinical
Thoracic and Cardiovascular Surgery, 2015, 22(11): 1080-1.
[12] Shin S H, Cha Y K, Kim J H, et al. Placental transmogrification of the lung: CT findings with pathologic correlation in six patients [J].
Journal of Thoracic Disease, 2023, 15(9): 4818-25.
[13] Schipper P H, Meyers B F, Battafarano R J, et al. Outcomes after resection of giant emphysematous bullae [J]. The Annals of thoracic
surgery, 2004, 78(3): 976-82; discussion -82.
[14] Zhu C, Chen Z, Chen B, et al. Thoracoscopic Treatment of Giant Pulmonary Bullae [J]. Journal of Surgical Research, 2019, 243:
206-12.
[15] Lin K-C, Luh S-P. Video-assisted thoracoscopic surgery in the treatment of patients with bullous emphysema [J]. International journal of
general medicine, 2010, 3: 215-20.
[16] Van Bael K, La Meir M, Vanoverbeke H. Video-assisted Thoracoscopic Resection of a Giant Bulla in Vanishing Lung Syndrome: case
report and a short literature review [J]. Journal of Cardiothoracic Surgery, 2014, 9.
[17] Kolodii M, Azzam S, Peer M. Thoracoscopic giant lung bullaectomy: our initial experience [J]. Journal of Cardiothoracic Surgery,
2022, 17(1).
[18] Gunnarsson S I, Johannesson K B, Gudjonsdottir M, et al. Incidence and outcomes of surgical resection for giant pulmonary bullae--a
population-based study [J]. Scand J Surg, 2012, 101(3): 166-9.
[19] Santini M, Fiorelli A, Vicidomini G, et al. Endobronchial treatment of giant emphysematous bullae with one-way valves: a new approach for surgically unfit patients [J]. European Journal of Cardio-Thoracic Surgery, 2011, 40(6): 1425-31.
[20] Zhong C H, You Z D, Li S Y. Application and innovation of bronchoscopic lung volume reduction with endobronchial valve [J]. Zhonghua jie he he hu xi za zhi, 2024, 47(11): 1015-8.
[21] Noppen M, Tellings J-C, Dekenkeleire T, et al. Successful treatment of a giant emphysematous bulla by bronchoscopic placement of endobronchial valves [J]. Chest, 2006, 130(5): 1563-5.
[22] Ding M, Gao Y-D, Dai L, et al. Endobronchial valves to treat a recurrent giant emphysematous bulla after bullectomy [J]. International
Journal of Tuberculosis and Lung Disease, 2016, 20(9): 1277-8.
[23] Goud A, Krimsky W, Caldwel M, et al. Percutaneous Bullectomy in Conjunction with Endobronchial Valve Placement as an Alternative
to Surgical Management of Giant Bullae [J]. Respiration, 2016, 91(6): 523-6.
[24] Im Y, Jeong B-H, Park H Y, et al. Expeditious Resolution of Giant Bullae with Endobronchial Valves and Percutaneous Catheter Insertion [J]. Yonsei medical journal, 2022, 63(2): 195-8.
[25] Mantri S, Macaraeg C, Shetty S, et al. Technical advances: measurement of collateral flow in the lung with a dedicated endobronchial
catheter system [J]. Journal of bronchology & interventional pulmonology, 2009, 16(2): 141-4.
[26] Gompelmann D, Eberhardt R, Slebos D-J, et al. Diagnostic performance comparison of the Chartis System and high-resolution computerized tomography fissure analysis for planning endoscopic lung volume reduction [J]. Respirology, 2014, 19(4): 524-30.
[27] Schuhmann M, Raffy P, Yin Y, et al. Computed Tomography Predictors of Response to Endobronchial Valve Lung Reduction Treatment
[J]. American Journal of Respiratory and Critical Care Medicine, 2015, 191(7): 767-74.
[28] Bhattacharyya p, Sarkar D, Nag S, et al. Transbronchial decompression of emphysematous bullae: a new therapeutic approach [J]. European Respiratory Journal, 2007, 29(5): 1003-6.
[29] Kanoh S, Kobayashi H, Motoyoshi K. Intrabullous blood injection for lung volume reduction [J]. Thorax, 2008, 63(6): 564-5.
[30] Zoumot Z, Kemp S V, Caneja C, et al. Bronchoscopic Intrabullous Autologous Blood Instillation: A Novel Approach for the Treatment
of Giant Bullae [J]. Annals of Thoracic Surgery, 2013, 96(4): 1488-91.
[31] Kemp S V, Zoumot Z, Shah P L. Three-Year Follow-Up of a Patient with a Giant Bulla Treated by Bronchoscopic Intrabullous Autologous Blood Instillation [J]. Respiration, 2016, 92(4): 283-4.
[32] Li W L, Li Y H, Yang Y B, et al. Intrabullous Adhesion Pexia (IBAP) by Percutaneous Pulmonary Bulla Centesis: An Alternative for the
Surgical Treatment of Giant Pulmonary Bulla (GPB) [J]. Canadian Respiratory Journal, 2018, 2018.
[33] Bhattacharyya P, Bardhan S, Nag S, et al. Transthoracic decompression of emphysematous bulla: a novel experience [J]. The Indian
journal of chest diseases & allied sciences, 2011, 53(1): 51-3.
[34] Zhao X Y, Cao H C, Wang Z Y, et al. Observation on the clinical efficacy of OB glue in the treatment of pulmonary bullae under CT
guide [J]. Journal of Interventional Radiology, 2013, 22(09): 747-9.
[35] Chen J B, Zhu J Q, Zeng X Y, et al. Clinical application of giant pulmonary bullae volume reduction surgery by CT-guided percutaneous
punctur [J]. Journal of Clinical Pulmonary Medicine, 2018, 23(02): 305-7.
[36] Chon S H, Shinn S H, Lee C B. Giant Fluid-Filled Bulla Treated by Instillation of Antibiotics after Percutaneous Drainage [J]. Thoracic
and Cardiovascular Surgeon, 2010, 58(2): 122-U69.
[37] Wang K, Zuo L, Tian P, et al. Beyond diagnosis: maximizing the role of medical thoracoscopy in pleural disease treatment [J]. Respiratory Research, 2024, 25(1).
[38] Zhang H, Wang L, Ge C S, et al. Efficacy and safety of argon plasma coagulation plus medical adhesive via thoracoscopy in the treatment of spontaneous pneumothorax with subpleural blebs [J]. National Medical Journal of China, 2018, 98(30): 2448-51.
[39] Zhang H, Wang L, Ge C S, et al. Efficacy and safety of giant emphysematous bulla volume reduction via medical thoracoscope [J]. National Medical Journal of China, 2021, 101(30): 2370-4.
[40] Lu H, Li Z H, Yu Y H, et al. Efficacy and Safety of Medical Thoracoscopic Bulla Volume Reduction in the Treatment of Chronic Obstructive Pulmonary Disease Combined With Giant Emphysematous Bullae [J]. Journal of Sichuan University (Medical Sciences), 2024,
55(02): 403-10.
[41] Zhang H, Duan C L, Xue G W, et al. Effectiveness and safety of medical glue assisted argon plasma coagulation union giant emphysematous bulla volume reduction via thoracoscope on the treatment of spontaneous pneumothorax with subpleural bullae [J]. Zhonghua
Jie He He Hu Xi Za Zhi, 2022, 45(12): 1204-8.
[42] Zhang H, Xu W W, Chen C D, et al. A prospective study of position selection combined with autologous blood intrathoracic infusion in
the treatment of postoperative persistent air leakage with an unexpanded lung [J]. Zhonghua jie he he hu xi za zhi, 2023, 46(4): 404-7.
[43] Lin B Z, Zhao L, Wang H W, et al. Progress in Bioadhesive Hydrogels [J]. Journal of Functional Polymers, 2020, 33(02): 125-40.
[44] Joglekar M M, Slebos D-J, Leijten J, et al. Crosslink bio-adhesives for bronchoscopic lung volume reduction: current status and future
direction [J]. European Respiratory Review, 2021, 30(162).
[45] Pinkas O, Goder D, Noyvirt R, et al. Structuring of composite hydrogel bioadhesives and its effect on properties and bonding mechanism [J]. Acta Biomaterialia, 2017, 51: 125-37.
[46] Liu X Y, Zhang X R, Zhang Y H, et al. Preparation and Drug Release Properties of Self-Adhesive, NIR-Responsive Hydrogels [J].
Chemistry Bulletin 2024, 87(07): 850-6.
[47] Ma P, Liang W, Huang R, et al. Super-Structured Wet-Adhesive Hydrogel with Ultralow Swelling, Ultrahigh Burst Pressure Tolerance,
and Anti-Postoperative Adhesion Properties for Tissue Adhesion [J]. Advanced Materials, 2024, 36(11).
[48] Zhang K, Wang Q H, Jia C N, et al. Preparation and Characterization of High Viscoelastic Tissue Sealant [J]. Polymer Materials Science
& Engineering, 2024, 40(09): 26-35.
[49] Guo Z, Xiong Y, Zhang S, et al. Naturally derived highly resilient and adhesive hydrogels with application as surgical adhesive [J]. International Journal of Biological Macromolecules, 2023, 253.
[50] Assmann A, Vegh A, Ghasemi-Rad M, et al. A highly adhesive and naturally derived sealant [J]. Biomaterials, 2017, 140: 115-27.
[51] Annabi N, Zhang Y-N, Assmann A, et al. Engineering a highly elastic human protein-based sealant for surgical applications [J]. Science
Translational Medicine, 2017, 9(410).
[52] Gasek N, Park H E, Uriarte J J, et al. Development of alginate and gelatin-based pleural and tracheal sealants [J]. Acta Biomaterialia,
2021, 131: 222-35.
[53] Haghniaz R, Montazerian H, Rabbani A, et al. Injectable, Antibacterial, and Hemostatic Tissue Sealant Hydrogels [J]. Advanced Healthcare Materials, 2023, 12(31).
[54] Byrd R P, JR., Roy T M. Spontaneous resolution of a giant pulmonary bulla: what is the role of bronchodilator and anti-inflammatory
therapy? [J]. Tennessee medicine: journal of the Tennessee Medical Association, 2013, 106(1): 39-42.
[55] Nakahara K, Nakaoka K, Ohno K, et al. Functional indications for bullectomy of giant bulla [J]. The Annals of thoracic surgery, 1983,
35(5): 480-7.
[56] Palla A, Desideri M, Rossi G, et al. Elective surgery for giant bullous emphysema: a 5-year clinical and functional follow-up [J]. Chest,
2005, 128(4): 2043-50.
[57] Krishnamohan P, Shen K R, Wigle D A, et al. Bullectomy for Symptomatic or Complicated Giant Lung Bullae [J]. Annals of Thoracic
Surgery, 2014, 97(2): 425-31.
DOI: http://dx.doi.org/10.70711/pmr.v2i4.6120
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