Giant pulmonary bulla (GPB) or giant emphysematous bulla (GEB), a bulla occupying more than one-third of the involved hemithorax, usually requires removal by surgical procedures such as bullectomy or lobectomy.
In this study, we introduce an alternative convenient procedure named intrabullous adhesion pexia (IBAP) involving computer tomography (CT)-guided percutaneous pulmonary bulla centesis, IBAP with biomedical fibrin sealant, and closed intracavity drainage under continuous negative pressure.
Percutaneous pulmonary bulla centesis was performed by omnidirectional injection into the GPB with 10 ml of porcine fibrin sealant such that the biological glue could be distributed evenly within the target bulla.
It is generally believed that a single small pulmonary bulla, which has negligible influence on lung functions, does not necessarily require treatment.
It is hypothesized that stopping one-way aerating manner of pulmonary bulla by injection of fibrin sealant into the target GPB followed by closed intracavity drainage under continuous negative pressure could achieve closure of GPB immediately.