In 5 cases, an infectious giant bulla was opened with the use of video
-assisted thoracoscopic surgery (VATS). Because all bullae adhered to
the thoracic wall and were noncommunicating with the airway, they were
opened without complete resection, leaving their inside walls at the
lung and lateral walls on the thoracic wall. The expansion of remnant
lung was excellent, and postoperative air leakage did not occur in any
case. The postoperative vital capacity and FEV, improved significantl
y over the preoperative condition (p < 0.01). Because the bronchial co
mmunication of bulla is frequently obliterated after infection within
the bulla, opening of a bulls is curative and simpler, more effective,
and less invasive than complete resection.