LARGE LUNG AIR CYSTS

Large lung air cysts represent cysts of different sizes, that are located sub-pleurally or deeply throughout the lung parenchyma. These cysts may have extremely large size, and may occupy the whole pleural cavity, and frequently without causing any symptoms.
Although these cysts may be of very large size, rarely are they the cause of pneumothorax, and this is their main difference from the sub-pleural blebs, of which the rupture is the most common cause of spontaneous pneumothorax.
The large lung air cysts need resection because they may get infected and that makes their treatment more difficult technically, and the patient has increased possibilities to develop peri-operative complications, which may lead to breathing insufficiency. Another reason why these cysts need resection is not only because they occupy large part of the hemitorax, but they do not allow the remaining lung tissue which has normal function to participate in the whole respiratory function.
Furthermore it has been reported that these cysts may be the site where bronchogenic cancer may develop.
Something that is worth mentioning is that the Thoracic Surgeon need to follow strict surgical rules, which necessitate the resection of the cyst or cysts, without sacrificing any well functioning lung parenchyma. There is no need to perform lobectomy, even more segmentectomy. Also it is of great important to minimize the postoperative air leak. This may be achieved, using suitable staplers, synthetic leaflets of modified bovis pericardium, to reinforce the suture line in combination with the use of tissue glue. This procedure is very effective and it is well known that it reduces the postoperative air leak.