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Lung Surgery Eases Emphysema Symptoms

Lung Volume Reduction Surgery May Provide Long-Term Benefits for Some

WebMD Health News

March 25, 2003 -- A surgical procedure that gives the lungs of emphysema patients more room to breathe may provide lasting benefits for people with the most severe form of the disease. New research shows that the procedure, known as lung volume reduction surgery (LVRS), can significantly improve the overall health and quality of life for these patients for as long as five years following the procedure.

The study appears in the March issue of The Journal of Thoracic and Cardiovascular Surgery.

Emphysema is most commonly caused by smoking and is one of the leading causes of disability in the U.S. It's a chronic disease in which tiny air sacs in the lungs become stretched and enlarged, so they are less able to supply oxygen to the blood. The lungs become larger than normal and air is trapped in spaces, making breathing more difficult.

Until recently, a lung transplant was the only treatment option for people with advanced forms of the rapidly progressing disease. Since lung volume reduction surgery was introduced about 20 years ago, it has become a popular treatment alternative for people with the most severe forms of emphysema. But since these are also the sickest patients, LVRS also comes with significant risks.

Lung volume reduction surgery involves removal the most diseased parts of the lung to give the lungs more room to expand and allow normal breathing.

"This procedure is not a cure for emphysema," says researcher Joel D. Cooper, MD, head of the division of cardiothoracic surgery at the Washington University School of Medicine in St. Louis, in a news release. "No matter how successful the operation, emphysema continues to degrade the lungs and progressively impairs breathing. However, our results confirm that LVRS can in fact extend patients' lives and allow them to continue participating in normal activities of daily living."

In the study, researchers followed the first 250 patients to receive lung volume reduction surgery between January 1993 and June 2000 at Barnes-Jewish Hospital in St. Louis for an average of almost five years.

At the end of the follow-up period, more than 60% of the 250 patients were still alive and only 18 required a lung transplant following LVRS. Researchers say that without the surgery, about half of these patients would have died within three years.

The study showed the patients still had measurable improvements in lung function five years after lung volume reduction surgery. Nearly 80% of the people in the study said their overall quality of life was still better five years later compared with before the surgery.

But the researchers admit that lung volume reduction surgery isn't for everyone with emphysema. In fact, some studies have questioned the effectiveness of LVRS because of the significant risks associated with the procedure.

"We strongly believe that patient selection is one of the keys to success for this procedure," says Cooper.

In fact, all of the participants in this study were enrolled in a rehabilitation program for three months prior to LVRS to ensure they were as healthy as possible before the operation.

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