COPD is characterized by progressive airflow obstruction in the formation of abnormal enlargement of the terminal bronchioles that is associated with airway wall destruction without causing fibrosis.Surgical treatment includes resection of the bullae, volumereductive surgery (LVRS lung volume-Reducing Surgery) and transplantation. Bulektomy requires thorough cooperation of pneumologist, radiologist and surgeon.
It is necessary to pinpoint patients with clear indications for surgery and to locate resection not to lead to progression of left buls. Excellent results reported resection of a giant bull.
Volumereductive operations are chrakterised by resection of peripheral parts of both lungs in order to provide better ventilation of the remaining parenchyma.