hLung Volume Reduction Surgery Proven Beneficial to Emphysema Patients

Lung volume reduction surgery (LVRS) may improve the quality of life and overall well-being in patients with severe emphysema, according to the National Emphysema Treatment Trial (NETT), the first study to randomize emphysema patients to receive LVRS or non-surgical medical care.

Researchers for NETT recruited 1,218 patients with severe emphysema and randomized them to either undergo LVRS or non-surgical medical treatment which consisted of customized use of medication, oxygen support, smoking cessation and pulmonary rehabilitation. Of the sampled population, 608 patients underwent LVRS and 610 received standard medical care. They were monitored for five years, or until a “composite event” (a serious decline in quality of life or death) occurred. The average time until such an event was one year for medically treated patients and two years for patients who underwent LVRS.

“We found lung reduction surgery is good treatment alternative for selected emphysema patients since it not only improves survival but also meaningfully improves quality of life for a period of at least five years after the operation,” said lead author of the study, Roberto Benzo, M.D., MSc., Mayo Clinic. “Patients who underwent LVRS, with the exception of those who had non-upper-lobe-predominant emphysema, had both a survival and quality of life benefit when compared to similar patients undergoing medical treatment only.”

For patients who received LVRS, a portion of the emphysematous lung tissue was removed to prevent “air-trapping,” where the patient can inhale but is unable to force the air back out of the lung.

“By removing the section of lung that is primarily affected with severe emphysema, we can decrease air trapping and consequently the shortness of breath, which can thereby improve the patient's perceived quality of life,” said Dr. Benzo.

Researchers caution that LVRS carries serious risks. In the study, nearly 5% of the patients who underwent LVRS died following surgery. However, once the post-operative period is over, the patients’ quality of life is improved immediately. Full Story