Sixteen patients with bilateral bullous lung disease have been operated on. One-stage surgical interventions--bullectomy and parietal pleurectomy--have been performed on both sides through a transsternal approach. There was a complication in one case: relaxation of the right hemidiaphragm as a result of phrenic nerve injury. Expansion of compressed lung tissue was achieved in all cases. Long-term follow-up for 5 years showed that perfusion and ventilation of lung parenchyma improved. Pneumothorax did not occur in any case. We concluded that the transsternal approach is the method of choice in the surgery of bilateral bullous lung disease, and parietal pleurectomy prevents spontaneous pneumothorax. Organ-sparing operations improve pulmonary function in patients with bullous lung disease.