Patients with large intrapulmonary emphysematous bullae present a considerable therapeutic problem, particularly if their respiratory reserve is low, because of the risks of open operation. The method of draining intrapulmonary cavities, pioneered by Monaldi for the treatment of tuberculosis, is here described as applied to emphysematous bullae. Thirty-one patients were treated by intracavity suction and drainage. There were two operative deaths (6.5%). Apart from infection, no other significant postoperative complications ensued. Radiographic improvement occurred in all patients but one (96.7%). Where forced expiratory volume in one second and vital capacity were measured improvement was obtained in five out of six patients. Symptomatic improvement, which generally corresponded well to improvement in respiratory function tests, occurred in 28 patients (90.3%), all but one of whom survived.
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