Can bullae heal themselves after quitting smoking?

Bullous lung disease is an irreversible form of lung damage. There is currently no effective drug for treatment. The most common treatment is surgery, which is the only treatment method. There are many causes of bullae, and smoking is closely related to them. Therefore, patients must quit smoking in time. Quitting smoking cannot cure bullae, but it can give the lungs a significant rest and recuperation.

Treatment principles: Bullae are an irreversible lung disease and there is no effective drug treatment. Surgery is the only treatment option, but not all patients with bullae require surgery. Incidentally discovered asymptomatic bullae generally do not require treatment. For patients with chronic bronchitis or emphysema, the primary lesion should be treated mainly. If secondary infection occurs, antibiotics should be used. If the bulla is larger than 1/3 to 1/2 of one side of the chest cavity, it is called a giant bulla. Because it can compress the surrounding lung tissue and change the ventilation-perfusion ratio, surgery can achieve good results. If intraparenchymal bullae are widespread, surgical treatment is only palliative.

The indications for surgery are: 1. Patients with large bullae that occupy more than 1/3 to 1/2 of the chest cavity on one side and clinical symptoms, but no other lesions in the lungs, can undergo surgical resection of the bullae to re-expand the compressed lung tissue, increase the breathing area, eliminate intrapulmonary shunt, increase arterial oxygen partial pressure, reduce airway resistance, increase ventilation volume, and improve the patient's symptoms of dyspnea such as chest tightness and shortness of breath (Figure 2). 2. Spontaneous pneumothorax caused by ruptured bullae can be cured by non-surgical treatments such as thoracentesis and closed chest puncture, but recurrent spontaneous pneumothorax should be treated surgically. During the operation, the bullae are ligated or sutured, and pleural friction can be used to keep the pleura adhered and fixed to prevent recurrence of pneumothorax. 3. The clinical symptoms of patients with hemothorax are sometimes very severe, often with chest pain, dyspnea, and a series of manifestations of internal bleeding. Clinically, the changes in the condition should be closely observed, and non-surgical measures such as blood transfusion and thoracentesis should be taken in a short period of time. When there is no obvious improvement in symptoms, thoracotomy should be performed decisively. At this time, there is often heavy active bleeding. Non-surgical treatment and observation for too long often delay the disease, and the prognosis is not as good as surgical hemostasis.

4. Active surgical treatment is recommended for patients with recurrent bullous infections. During surgery, as much healthy lung tissue as possible should be preserved, and only bullae resection and suture should be performed, or local lung tissue wedge resection should be performed to avoid unnecessary loss of lung function.

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