Center for Thoracic Oncology
The Center for Thoracic Oncology at Boston Medical Center is dedicated to providing the most advanced and effective medical treatment in New England. In addition to our expertise and state-of-the-art facilities, our caring staff offers a patient experience that is second to none. We perform such innovative procedures as bullectomy, and will guide you on the path to recovery as quickly and as comfortably as possible.
Bullectomy is the surgical removal of a bulla, which is an air pocket in the lung that is greater than one centimeter in diameter (across). Bullae tend to occur as a result of lung tissue destruction and diseases such as cancer and emphysema. Their presence in the lung takes up space, causes pressure and blocks your breathing. You may experience:
- Pressure in the chest
- Difficulty breathing
- A bloated feeling
Bullae are often diagnosed with x-rays or computed tomography (CT) scans. Bullectomy is typically not a cure for the cause of the bulla, but it may greatly improve symptoms.
How to Prepare
It is important to follow any instructions given to you by your physician to prepare for surgery. These instructions generally include:
- Refraining from eating or drinking anything after midnight on the night before
- Bringing all of your medications with you to the hospital
- Arriving one hour before your surgery time
You may have a pre-admission appointment one to two weeks beforehand, in which you will have routine blood testing; any heart, lung, or esophageal imaging; and a meeting with the anesthesiologist, who will give you medicine during your procedure that puts you to sleep and eases pain.
If possible, do some mild physical activity, such as walking, and eat a balanced diet leading up to your scheduled surgery. In the week before, follow the guidelines below:
- Limit alcohol consumption to one to two glasses a day.
- Stop using tobacco or cut back on the number of cigarettes you smoke each day.
- Make a list of all medications you take and bring it with you. Include prescription and over-the-counter medications, herbs, supplements, aspirin, and corticosteroids.
What to Expect
On the day before your procedure, you should receive a call from us. You will be given information about the day of your bullectomy, including where to go and when to arrive. Leave any jewelry, credit cards, or other valuables at home, and wear comfortable clothes.
When you arrive, you will be taken to a pre-surgery area so that we can take your temperature, blood pressure, pulse, and listen to your heart and lungs. We will place an intravenous (IV) line in your arm, so that medications and fluids may be administered before, during and after the procedure. The anesthesiologist will give you medicine to fall asleep.
Bullectomy is often done by thoracotomy, in which a four to six-inch incision is made, usually below your armpit, or by video thoracoscopy, where small incisions are made on the side of your chest. A thin, lighted tube called a thoracoscope, as well as surgical tools, are inserted through catheters (tubes). In video thoracoscopy, a video screen and console guides the surgeon as he or she removes the bulla. Once it is removed, your surgeon will close the incision(s).
After surgery, you will be taken to the Post Anesthesia Unit and watched closely for any changes in blood pressure, heart rate, and breathing. An IV line will remain in your arm to keep you hydrated and to give you pain medication, if necessary. If a breathing tube was inserted during surgery to control your breathing, it may remain in place for a brief time. Your stay with us will range from one night to several, depending on the healing process and the procedure used.
Before you go home, your physician or nurse will teach you how to care for your incision. Gradually, over the course of a few weeks, you will regain your strength and be able to return to work and participate in physical activity. Be sure to call your doctor if you notice any of the following:
- High temperature
- Allergic reaction, such as redness, swelling, trouble breathing
Always take your medicine exactly as prescribed. Call us if you have any questions or changes.