Lung Surgery No Help for Some Emphysema Patients

A study has found that certain advanced emphysema patients not only receive little benefit from lung volume reduction surgery (LVRS) but are at unacceptable risk of death from the procedure. Conducted by researchers from Columbia Presbyterian Medical Center (NY, NY, USA), the study is to appear in the October 11, 2001, issue of The New England Journal of Medicine (NEJM). However, because of the importance of the results, the editors have already posted the study findings on the journal's website.

The study, called NETT (National Emphysema Treatment Trial), is a five-year, multicenter randomized trial designed to evaluate the role of LVRS in the treatment of severe emphysema. Of the 1,033 current participants, 140 met the high-risk criteria and 69 underwent surgery. These patients had a 16% 30-day mortality rate. In contrast, no deaths were reported in the medical treatment group. Furthermore, high-risk patients who survived the surgery were found to have only slightly improved functional outcomes and quality-of-life scores six months later. As a result of these findings, the study is no longer enrolling high-risk patients in the study.

"This is exactly the kind of insight we hope to gain from NETT,” said Dr. Claude Lenfant, director of the U.S. National Heart, Lung, and Blood Institute, the primary sponsor of the study. "We expect the final results of NETT will guide us further in determining if and when this procedure should be used to treat emphysema.”