Successful video-assisted thoracoscopic bullectomy and Nd-YAG laser ablation

We report here two cases of giant/multiple emphysematous bullae treated with video-assisted thoracoscopy. The first case was a 35-year-old male who was referred to our hospital because an abnormal shadow was casually pointed out in a chest roentgenogram. Chest computed tomographic scan showed giant bulla in the left upper lobe. The second patient was a 37-year-old male who had a symptom of shortness of breath on exertion. Chest roentgenogram and computed tomographic scan revealed multiple bullae at bilateral apical regions. They were performed resection of bulla with stapler and Nd-YAG laser ablation to the emphysematous surroundings using video-assisted thoracoscopy. They had recovered sufficiently to be discharged from our hospital. We think Nd-YAG laser ablation is effective to prevent postoperative air leakage and recurrence of bullae because it makes surrounding tissue tight and continuous.