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The Dangers of Emphysema Surgery

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Oct. 10, 2001 -- A popular surgery for emphysema might not be so popular anymore, since researchers who reviewed the results of the operation found the procedure could be dangerous and even deadly to those with severe cases of the disease.

The news was pressing enough for the researchers to jump the gun and announce the results of the lung-surgery study in August. The researchers have officially released their findings in the Oct. 11 issue of The New England Journal of Medicine.

Lung damage from emphysema is primarily tied to smoking, and each year it strikes about 2 million Americans. Doctors had been trying to determine if it would be helpful to take out parts of the damaged lung tissue to treat some of these people.

The National Institutes of Health started to investigate and found that when people with severe forms of the disease had the surgery, 16% died within a month of the operation. In contrast, none of the 70 patients treated with medication and diet died within the first four weeks of their treatment.

The new study found that over three years, surgery patients were four times more likely to die than the other group getting more conservative treatment. Also, those who survived the surgery saw only small improvement in their breathing or quality of life.

In August, researchers severely restricted the number of patients who could get the surgery, limiting it to about 1,000 emphysema patients who might still benefit from it.

Over the past few years, doctors had shown a lot of optimism with this surgery. In 1999, for example, the American College of Chest Physicians assembled in Chicago and learned the procedure looked promising. Researchers had followed nearly 200 patients who received the surgery in St. Louis to treat their severe emphysema. The team found that 94% survived and 71% were still alive five years later.

The doctors had asked the patients to fill out a questionnaire on their quality of life before the procedure and again once a year. About 75% of the patients reported improved scores.

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