- For people with moderately severe emphysema, lung volume reduction surgery is considered the only surgical alternative to lung transplantation.
More than two million Americans have emphysema, and some of them—those who have emphysema that predominantly affects the upper lobes and low exercise capacity—may benefit from surgery called lung volume reduction surgery to remove diseased lung tissue. The procedure is believed to create more space in the chest cavity for the working lung tissue to expand.
For people with moderately severe emphysema, the procedure is considered the only surgical alternative to lung transplantation. However, volume reduction surgery is risky because lung function is already compromised and patients with emphysema are generally older and likely to be in poor health.
The first large study examining the risks and benefits of lung volume reduction surgery to treat emphysema showed patterns when researchers categorized patients based on the type and symptoms of their emphysema. Patients with predominantly upper-lobe emphysema and low exercise capacity before the surgery had the greatest benefit: Their mortality rate was cut in half compared with the medical therapy group, and their exercise capacity improved. Patients who had emphysema throughout their lungs but were still able to exercise benefited the least from surgery: They had twice the mortality rate of the medical therapy group and had little or no improvement in exercise capacity.
Although identifying these patient subgroups after the conclusion of the study is not statistically ideal, the findings are still considered valuable. Now doctors have a better way to know which of their patients with severe emphysema are most likely to benefit from lung volume reduction surgery.
In response to the study, Medicare now covers the procedure for appropriate candidates with emphysema.
