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Chronic obstructive pulmonary disease (COPD) weakens
the structure of the lung and may also damage the tiny air sacs (alveoli) in
the lung. When these air sacs break down, larger airspaces known as bullae are
Bullae sometimes can become so large that they interfere with
breathing and may cause complications:
For some people, surgically removing the enlarged air sacs—known as
a bullectomy—makes breathing easier. But few people are considered good
candidates for a bullectomy. It may work best for people with COPD who are
young, have large bullae that are grouped in just one area of the lung, and do
not have severe blockage in their airways. A
bullectomy may be considered if the bullae:
Bullectomy may make the lungs work better so more oxygen gets into
If there are many bullae spread throughout the lungs, surgery is not
likely to be helpful. In this case, other areas of the lung often become
damaged after the surgery. The best surgical results happen when there is
only one bulla or only a few that are all clustered in one area.
Long-term follow-up studies have begun to show that within 3 to 5
years after surgery, lung function deteriorates to the level it was before
The decision about whether to do the surgery is difficult and
usually is based on the doctor's experience and the person's overall
Bullae can be removed using a laser. But this method has not been
found to have an advantage over traditional surgery.
Hanania NA, et al. (2003). The efficacy and safety of fluticasone propionate (250 micrograms)/salmeterol (50 micrograms) combined in the Diskus Inhaler for the treatment of COPD. Chest, 124: 834–843.
February 19, 2013
E. Gregory Thompson, MD - Internal Medicine & Ken Y. Yoneda, MD - Pulmonology
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