{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T13:16:16Z","timestamp":1784207776836,"version":"3.55.0"},"reference-count":15,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Noncommunicable Chronic DiseasesNational Science and Technology Major Project","award":["2024ZD0522604 \/ 2024ZD0522600 to S Li"],"award-info":[{"award-number":["2024ZD0522604 \/ 2024ZD0522600 to S Li"]}]},{"name":"Noncommunicable Chronic DiseasesNational Science and Technology Major Project","award":["2024ZD052950X \/ 2024ZD0529500 to D Liu"],"award-info":[{"award-number":["2024ZD052950X \/ 2024ZD0529500 to D Liu"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82570148"],"award-info":[{"award-number":["82570148"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"1\u00b73\u00b75Project of State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University","award":["RHM24206"],"award-info":[{"award-number":["RHM24206"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Giant emphysematous bulla (GEB) is a form of emphysematous lung destruction and patients experience progressive dyspnea and decline in quality of life. Conventional surgical reduction is not available for all patients, especially those in poor condition, and a less invasive approach is needed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the feasibility and preliminary clinical outcomes of medical thoracoscopic bulla volume reduction for GEB.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Single-center retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A total of 35 GEB patients who underwent medical thoracoscopic bulla volume reduction were retrospectively analyzed. Preoperative and postoperative clinical data and chest computed tomography were collected. The feasibility of the technique was evaluated by radiological changes (bullae volume and diameter) and postoperative complications. Improvement in dyspnea was assessed using the modified Medical Research Council (mMRC) dyspnea scale. Accessible six-minute walk distance (6MWD) and spirometry test follow-up data were analyzed to assess preliminary clinical functional improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The targeted bulla volume was 1183.8\u2009\u00b1\u2009636.7\u2009mL preoperatively and decreased to 169.2\u2009\u00b1\u2009237.2\u2009mL postoperatively, representing an 87.7\u2009\u00b1\u200917.1% decrease compared to the baseline. A total of 91.4% (32\/35) of the patients achieved more than 50% volume reduction relative to baseline, and the diameter of the targeted bulla also showed a significant decrease (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). Nine subcutaneous emphysema cases and one thoracic infection case were reported as postoperative complications. In the overall population, the mMRC score decreased by 1.2\u2009\u00b1\u20090.6\u2009points at the 6-month follow-up. Available follow-up data on 6MWD and spirometry tests also showed improvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Medical thoracoscopic bulla volume reduction may represent a feasible and less invasive therapeutic option for patients with GEB and demonstrated preliminary clinical outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666261465491","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T13:23:15Z","timestamp":1783948995000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Feasibility and preliminary clinical outcomes of medical thoracoscopic bulla volume reduction for giant emphysematous bulla"],"prefix":"10.1177","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-5773-1039","authenticated-orcid":false,"given":"Rui","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinmiao","family":"Du","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Zuo","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingyu","family":"Shi","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongxiao","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Zhang","sequence":"additional","affiliation":[{"name":"Hangzhou Broncus Medical Co., Ltd., Hangzhou, Zhejiang Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan Province 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4824-7485","authenticated-orcid":false,"given":"Kaige","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, 37 Guoxue Lane, Wuhou District, Chengdu, Sichuan Province 610041, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,13]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.58.7.634"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2004.04.005"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.44.7.533"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/03000605211001989"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13019-020-01246-4"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2025.09.004"},{"key":"e_1_3_4_9_2","first-page":"2370","article-title":"Efficacy and safety of giant emphysematous bulla volume reduction via medical thoracoscope","volume":"101","author":"Zhang H","year":"2021","unstructured":"Zhang H, Wang L, Ge CS, et al. Efficacy and safety of giant emphysematous bulla volume reduction via medical thoracoscope. Zhonghua Yi Xue Za Zhi 2021; 101: 2370\u20132374.","journal-title":"Zhonghua Yi Xue Za Zhi"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.109.2.540"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.128.4.2043"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejcts.2011.03.046"},{"key":"e_1_3_4_13_2","first-page":"1674","article-title":"Treatment of giant emphysamous bulla with endobronchial valves in patients with chronic obstructive pulmonary disease: a case series","volume":"6","author":"Tian Q","year":"2014","unstructured":"Tian Q, An Y, Xiao B-B, et al. Treatment of giant emphysamous bulla with endobronchial valves in patients with chronic obstructive pulmonary disease: a case series. 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