EFFECT OF BULLECTOMY ON DIAPHRAGM STRENGTH

Surgical removal of bullous lesions in selected patients with chronic obstructive pulmonary disease may significantly improve lung function, gas exchange, and functional status and reduce dyspnea. Proposed mech anisms by which bullectomy may produce these beneficial effects includ e (1) improving ventilation and perfusion matching by allowing compres sed viable lung to re-expand and participate in gas exchange; (2) rest oring outward elastic tension on small airways, thereby reducing airwa ys obstruction; and (3) reducing end-expiratory lung volume, thereby d iminishing the adverse effects of chronic hyperinflation on chest wall elastic recoil and inspiratory muscle force generation. In this repor t, we demonstrate the effect of bullectomy on transdiaphragmatic press ure generation, gas exchange, and exercise capacity in a patient with severe bullous emphysema who underwent unilateral bullectomy.