TY - CHAP M1 - Book, Section TI - Minimally Invasive Methods of Managing Giant Bullae: Monaldi Procedure A1 - Batirel, Hasan F. A1 - Zellos, Lambros A2 - Sugarbaker, David J. A2 - Bueno, Raphael A2 - Colson, Yolonda L. A2 - Jaklitsch, Michael T. A2 - Krasna, Mark J. A2 - Mentzer, Steven J. A2 - Williams, Marcia A2 - Adams, Ann PY - 2015 T2 - Adult Chest Surgery, 2e AB - Giant bullae are space-occupying lesions that cause compression of the surrounding lung parenchyma with impairment of lung function. The bullae arise from emphysematous projections of destroyed lung tissue. Hence they differ from blebs, which are localized collections of air between visceral pleural layers without underlying parenchymal disease.1 Giant bullae can be classified as three basic morphologic types: Type I bullae have a narrow neck and are superficial, type II are superficial as well but have a broad neck, and type III are both broad and deep.2 Giant bullae usually require surgical resection. A wide range of procedures from open excision to plication, drainage, video-assisted bullectomy, and lung resection can be applied.3 Developments in anesthesia and surgery have enabled surgeons to operate on patients with very limited pulmonary function; however, there is a subgroup of patients who carry a significant risk of prolonged air leak and respiratory complications following resection of giant bullae. In this group of patients a minimally invasive method, known as the Monaldi procedure, can be performed. The Monaldi procedure, named after the surgeon who first applied this technique, was used in the mid and late 20th century for drainage of apically located tuberculous cavities, lung abscesses, and subsequently of giant bullae.4 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesssurgery.mhmedical.com/content.aspx?aid=1105843995 ER -