Tratamiento de las bullas pulmonares mediante toracotomía frente a abordaje mínimamente invasivo

The most common causes of bullous emphysema include smoking, exposure to biomass, and α-1 antitrypsin deficiency.Symptoms include progressive dyspnea, productive cough, decreased exercise tolerance, and wheezing.Surgical management options include thoracotomy or video-assisted thoracoscopy.When choosing the ideal approach for each patient, the extent and location of the bullae, comorbidities, and risk of recurrence, among other factors, must be considered.We present two surgical cases: a 45-year-old woman with a history of biomass exposure and a giant bulla causing acute respiratory distress, successfully treated with thoracotomy; and a 25-year-old man who developed a spontaneous pneumothorax with associated subpleural cysts at high altitude, managed via video-assisted thoracoscopic bullectomy.