Lung Surgery Benefits Emphysema Patients

Lung-volume reduction surgery improves survival, reduces disability, and improves quality of life for selected emphysema patients, according to new research.

The eight-year long U.S. National Emphysema Treatment Trial (NETT) followed patients with severe emphysema at 17 clinical sites who were randomly divided into two groups: one that underwent lung-volume reduction surgery and another that received medical therapy only. The study examined mortality rates, ability to exercise, and the quality of life of the patients after two and up to five years post-surgery.

Five years after surgery, those with emphysema in the upper lobes of their lungs showed improvement in survival, exercise, and quality of life when compared to patients who were treated with standard medical therapy. These findings are consistent with those researchers saw after the two-year mark and demonstrate that the benefit from the operation is durable. Of the 1,218 patients, 24% had higher survival rates after the lung surgery and 58% were in a group that demonstrated improved exercise and quality of life.

"Based on our earlier findings, we knew those with upper-lobe emphysema would see some improvement. We now know the low-exercise group saw the most improvement in ability to exercise and in quality of life,” said principal investigator Keith Naunheim, M.D., director cardiothoracic surgery at Saint Louis University School of Medicine (MO, USA), who presented his findings at the 42nd annual meeting of the Society of Thoracic Surgeons in Chicago (IL, USA) during January 2006.

Those who did worst after the surgery had emphysema distributed throughout the lungs and/or in the lower portion of their lungs and had higher exercise capacities. "Based on these results, we would not recommend these patients undergo lung-volume reduction,” said Dr. Naunheim, noting that these patients didn't experience improvements in any of the three areas.



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Saint Louis University School of Medicine