Effect of Lung-Volume-Reduction Surgery in Patients with Severe Emphysema

doi:10.1056/NEJM200007273430402

Volume 343:239-245		July 27, 2000		Number 4

Effect of Lung-Volume–Reduction Surgery in Patients with Severe Emphysema

Duncan Geddes, F.R.C.P., Michael Davies, M.R.C.P., Hiroshi Koyama, Ph.D., David Hansell, F.R.C.R., Ugo Pastorino, M.D., John Pepper, F.R.C.S., Penny Agent, M.C.S.P., Paul Cullinan, M.R.C.P., Stephanie J. MacNeill, M.Sc., and Peter Goldstraw, F.R.C.S.

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ABSTRACT

Background Although many patients with severe emphysema haveundergone lung-volume–reduction surgery, the benefitsare uncertain. We conducted a randomized, controlled trial ofthe surgery in patients with emphysema. Patients with isolatedbullae were excluded because such patients are known to improveafter bullectomy.

Methods Potentially eligible patients were given intensive medicaltreatment and completed a smoking-cessation program and a six-weekoutpatient rehabilitation program before random assignment tosurgery or continued medical treatment. After 15 patients hadbeen randomized, the entry criteria were modified to excludepatients with a carbon monoxide gas-transfer value less than30 percent of the predicted value or a shuttle-walking distanceof less than 150 m, because of the deaths of 5 such patients(3 treated surgically and 2 treated medically).

Results Of the 174 subjects who were initially assessed, 24were randomly assigned to continued medical treatment and 24to surgery. At base line in both groups, the median forced expiratoryvolume in one second (FEV₁) was 0.75 liter, and the median shuttle-walkingdistance was 215 m. Five patients in the surgical group (21percent) and three patients in the medical group (12 percent)died (P=0.43). After six months, the median FEV₁ had increasedby 70 ml in the surgical group and decreased by 80 ml in themedical group (P=0.02). The median shuttle-walking distanceincreased by 50 m in the surgical group and decreased by 20m in the medical group (P=0.02). There were similar changeson a quality-of-life scale and similar changes at 12 monthsof follow-up. Five of the 19 surviving patients in the surgicalgroup had no benefit from the treatment.

Conclusions In selected patients with severe emphysema, lung-volume–reductionsurgery can improve FEV₁, walking distance, and quality of life.Whether it reduces mortality is uncertain.

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From the Departments of Respiratory Medicine (D.G., M.D., H.K., P.A., P.C., S.J.M.), Radiology (D.H.), and Thoracic Surgery (U.P., J.P., P.G.), Royal Brompton Hospital, London.

Address reprint requests to Professor Geddes at the Royal Brompton Hospital, London SW3 6LR, United Kingdom.

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Polkey, M. I. (2006). Surgical procedures in emphysema: any impact on dynamic hyperinflation?. ERR 15: 96-99 [Abstract] [Full Text]
Polkey, M. I., Hopkinson, N. S. (2006). Bronchoscopic lung volume reduction. ERR 15: 99-103 [Abstract] [Full Text]
Moore, A. J., Stubbings, A., Swallow, E. B., Dusmet, M., Goldstraw, P., Porcher, R., Moxham, J., Polkey, M. I., Ferenczi, M. A. (2006). Passive properties of the diaphragm in COPD. J. Appl. Physiol. 101: 1400-1405 [Abstract] [Full Text]
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Lopez, A. D., Shibuya, K., Rao, C., Mathers, C. D., Hansell, A. L., Held, L. S., Schmid, V., Buist, S. (2006). Chronic obstructive pulmonary disease: current burden and future projections. Eur Respir J 27: 397-412 [Full Text]
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Miller, J. D., Malthaner, R. A., Goldsmith, C. H., Goeree, R., Higgins, D., Cox, P. G., Tan, L., Road, J. D., Canadian Lung Volume Reduction Surgery Study, (2006). A Randomized Clinical Trial of Lung Volume Reduction Surgery Versus Best Medical Care for Patients With Advanced Emphysema: A Two-Year Study From Canada. Ann. Thorac. Surg. 81: 314-321 [Abstract] [Full Text]
Celli, B. R. (2006). Chronic Obstructive Pulmonary Disease: From Unjustified Nihilism to Evidence-based Optimism.. Proc Am Thorac Soc 3: 58-65 [Abstract] [Full Text]
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Barnes, P. J., Stockley, R. A. (2005). COPD: current therapeutic interventions and future approaches. Eur Respir J 25: 1084-1106 [Abstract] [Full Text]
Mineo, T. C., Ambrogi, V., Mineo, D., Fabbri, A., Fabbrini, E., Massoud, R. (2005). Bone Mineral Density Improvement After Lung Volume Reduction Surgery for Severe Emphysema. Chest 127: 1960-1966 [Abstract] [Full Text]
McKeoughl, Z J, Alison, J A, Bayfield, M S, Bye, P T.P (2005). Supported and unsupported arm exercise capacity following lung volume reduction surgery: a pilot study. Chronic Respiratory Disease 2: 59-65 [Abstract]
Yusen, R. D., Littenberg, B. (2005). Integrating Survival and Quality of Life Data in Clinical Trials of Lung Disease: The Case of Lung Volume Reduction Surgery. Chest 127: 1094-1096 [Full Text]
Miller, J. D., Berger, R. L., Malthaner, R. A., Celli, B. R., Goldsmith, C. H., Ingenito, E. P., Higgins, D., Bagley, P., Cox, G., Wright, C. D. (2005). Lung Volume Reduction Surgery vs Medical Treatment: For Patients With Advanced Emphysema. Chest 127: 1166-1177 [Abstract] [Full Text]
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Tutic, M., Bloch, K. E., Lardinois, D., Brack, T., Russi, E. W., Weder, W. (2004). Long-term results after lung volume reduction surgery in patients with {alpha}1-antitrypsin deficiency. J. Thorac. Cardiovasc. Surg. 128: 408-413 [Abstract] [Full Text]
Ost, D., Glassman, L., Fein, A. M., Marcus, P. (2004). Innovations in Lung Volume Reduction: The Non-Cutting Edge. Chest 126: 6-9 [Full Text]
Sutherland, E. R., Cherniack, R. M. (2004). Management of Chronic Obstructive Pulmonary Disease. NEJM 350: 2689-2697 [Full Text]
Lee, S. M, Wise, R., Sternberg, A. L, Tonascia, J., Piantadosi, S., National Emphysema Treatment Trial Research Group, (2004). Methodologic issues in terminating enrollment of a subgroup of patients in a multicenter randomized trial. Clin Trials 1: 326-338 [Abstract]
Laghi, F., Jubran, A., Topeli, A., Fahey, P. J., Garrity, E. R. Jr, de Pinto, D. J., Tobin, M. J. (2004). Effect of Lung Volume Reduction Surgery on Diaphragmatic Neuromechanical Coupling At 2 Years. Chest 125: 2188-2195 [Abstract] [Full Text]
Meyers, B. F., Yusen, R. D., Guthrie, T. J., Patterson, G. A., Lefrak, S. S., Davis, G. E., Cooper, J. D. (2004). Results of lung volume reduction surgery in patients meeting a National Emphysema Treatment Trial high-risk criterion. J. Thorac. Cardiovasc. Surg. 127: 829-835 [Abstract] [Full Text]
Dolmage, T.E., Waddell, T.K., Maltais, F., Guyatt, G.H., Todd, T.R.J., Keshavjee, S., van Rooy, S., Krip, B., LeBlanc, P., Goldstein, R.S. (2004). The influence of lung volume reduction surgery on exercise in patients with COPD. Eur Respir J 23: 269-274 [Abstract] [Full Text]
Mineo, T.C., Ambrogi, V., Pompeo, E., Elia, S., Mineo, D., Bollero, P., Nofroni, I. (2004). Impact of lung volume reduction surgery versus rehabilitation on quality of life. Eur Respir J 23: 275-280 [Abstract] [Full Text]
Mink, S. N., Gonzalez, X., Duke, K., Bautista, E., Tan, L. (2004). Lung Volume Reduction Surgery in Canine Model of Predominantly Upper Lobe Emphysema: Advantages of New Surgical System. Chest 125: 633-643 [Abstract] [Full Text]
Maxfield, R. A. (2004). New and Emerging Minimally Invasive Techniques for Lung Volume Reduction. Chest 125: 777-783 [Abstract] [Full Text]
Lomas, D A (2004). Lung volume reduction surgery: where are we now?. Chronic Respiratory Disease 1: 2-4
Chatila, W. M., Wynkoop, W. A., Vance, G., Criner, G. J. (2004). Smoking Patterns in African Americans and Whites With Advanced COPD. Chest 125: 15-21 [Abstract] [Full Text]
Celli, B. R. (2003). A 62-Year-Old Woman With Chronic Obstructive Pulmonary Disease. JAMA 290: 2721-2729 [Full Text]
Decramer, M. (2003). Treatment of chronic respiratory failure: lung volume reduction surgery versus rehabilitation. Eur Respir J 22: 47s-56s [Abstract] [Full Text]
Sin, D. D., McAlister, F. A., Man, S. F. P., Anthonisen, N. R. (2003). Contemporary Management of Chronic Obstructive Pulmonary Disease: Scientific Review. JAMA 290: 2301-2312 [Abstract] [Full Text]
Jorgensen, K., Houltz, E., Westfelt, U., Nilsson, F., Schersten, H., Ricksten, S.-E. (2003). Effects of Lung Volume Reduction Surgery on Left Ventricular Diastolic Filling and Dimensions in Patients With Severe Emphysema. Chest 124: 1863-1870 [Abstract] [Full Text]
Russi, E.W., Bloch, K.E., Weder, W. (2003). Lung volume reduction surgery: what can we learn from the National Emphysema Treatment Trial?. Eur Respir J 22: 571-573 [Full Text]
Oey, I. F., Morgan, M. D.L., Singh, S. J., Spyt, T. J., Waller, D. A. (2003). The long-term health status improvements seen after lung volume reduction surgery. Eur. J. Cardiothorac. Surg. 24: 614-619 [Abstract] [Full Text]
Munro, P. E., Bailey, M. J., Smith, J. A., Snell, G. I. (2003). Lung Volume Reduction Surgery in Australia and New Zealand: Six Years On: Registry Report. Chest 124: 1443-1450 [Abstract] [Full Text]
Snell, G. I., Holsworth, L., Borrill, Z. L., Thomson, K. R., Kalff, V., Smith, J. A., Williams, T. J. (2003). The Potential for Bronchoscopic Lung Volume Reduction Using Bronchial Prostheses: A Pilot Study. Chest 124: 1073-1080 [Abstract] [Full Text]
Calverley, P M A (2003). Closing the NETT on lung volume reduction surgery. Thorax 58: 651-653 [Full Text]
Laghi, F., Tobin, M. J. (2003). Disorders of the Respiratory Muscles. Am. J. Respir. Crit. Care Med. 168: 10-48 [Abstract] [Full Text]
Wijkstra, P. J., Lacasse, Y., Guyatt, G. H., Casanova, C., Gay, P. C., Meecham Jones, J., Goldstein, R. S. (2003). A Meta-analysis of Nocturnal Noninvasive Positive Pressure Ventilation in Patients With Stable COPD. Chest 124: 337-343 [Abstract] [Full Text]
Meyers, B F, Patterson, G A (2003). Chronic obstructive pulmonary disease * 10: Bullectomy, lung volume reduction surgery, and transplantation for patients with chronic obstructive pulmonary disease. Thorax 58: 634-638 [Abstract] [Full Text]
Appleton, S., Adams, R., Porter, S., Peacock, M., Ruffin, R. (2003). Sustained Improvements in Dyspnea and Pulmonary Function 3 to 5 Years After Lung Volume Reduction Surgery. Chest 123: 1838-1846 [Abstract] [Full Text]
Takayama, T., Shindoh, C., Kurokawa, Y., Hida, W., Kurosawa, H., Ogawa, H., Satomi, S. (2003). Effects of Lung Volume Reduction Surgery for Emphysema on Oxygen Cost of Breathing. Chest 123: 1847-1852 [Abstract] [Full Text]
National Emphysema Treatment Trial Research Group, (2003). A Randomized Trial Comparing Lung-Volume-Reduction Surgery with Medical Therapy for Severe Emphysema. NEJM 348: 2059-2073 [Abstract] [Full Text]
National Emphysema Treatment Trial Research Group, (2003). Cost Effectiveness of Lung-Volume-Reduction Surgery for Patients with Severe Emphysema. NEJM 348: 2092-2102 [Abstract] [Full Text]
Drazen, J. M., Epstein, A. M. (2003). Guidance Concerning Surgery for Emphysema. NEJM 348: 2134-2136 [Full Text]
Goldstein, R S, Todd, T R J, Guyatt, G, Keshavjee, S, Dolmage, T E, van Rooy, S, Krip, B, Maltais, F, LeBlanc, P, Pakhale, S, Waddell, T K (2003). Influence of lung volume reduction surgery (LVRS) on health related quality of life in patients with chronic obstructive pulmonary disease. Thorax 58: 405-410 [Abstract] [Full Text]
Yusen, R. D., Lefrak, S. S., Gierada, D. S., Davis, G. E., Meyers, B. F., Patterson, G. A., Cooper, J. D. (2003). A Prospective Evaluation of Lung Volume Reduction Surgery in 200 Consecutive Patients. Chest 123: 1026-1037 [Abstract] [Full Text]
Ciccone, A. M., Meyers, B. F., Guthrie, T. J., Davis, G. E., Yusen, R. D., Lefrak, S. S., Patterson, G. A., Cooper, J. D. (2003). Long-term outcome of bilateral lung volume reduction in 250 consecutive patients with emphysema. J. Thorac. Cardiovasc. Surg. 125: 513-525 [Abstract] [Full Text]
MacNee, W, Calverley, P M A (2003). Chronic obstructive pulmonary disease * 7: Management of COPD. Thorax 58: 261-265 [Abstract] [Full Text]
Ingenito, E. P., Berger, R. L., Henderson, A. C., Reilly, J. J., Tsai, L., Hoffman, A. (2003). Bronchoscopic Lung Volume Reduction Using Tissue Engineering Principles. Am. J. Respir. Crit. Care Med. 167: 771-778 [Abstract] [Full Text]
Ingenito, E. P., Loring, S. H., Moy, M. L., Mentzer, S. J., Swanson, S. J., Reilly, J. J. (2003). Physiological characterization of variability in response to lung volume reduction surgery. J. Appl. Physiol. 94: 20-30 [Abstract] [Full Text]
Beckles, M. A., Spiro, S. G., Colice, G. L., Rudd, R. M. (2003). The Physiologic Evaluation of Patients With Lung Cancer Being Considered for Resectional Surgery. Chest 123 : 105S-114S [Abstract] [Full Text]
Mineo, T. C., Ambrogi, V., Pompeo, E., Bollero, P., Mineo, D., Nofroni, I. (2002). Body weight and nutritional changes after reduction pneumoplasty for severe emphysema: A randomized study. J. Thorac. Cardiovasc. Surg. 124: 660-667 [Abstract] [Full Text]
Stoica, S. C., Craig, S. R., Soon, S. Y., Walker, W. S. (2002). Spontaneous rupture of the right hemidiaphragm after video-assisted lung volume reduction operation. Ann. Thorac. Surg. 74: 929-931 [Abstract] [Full Text]
Bloch, K. E., Weder, W., Boehler, A., Zalunardo, M. P., Russi, E. W. (2002). Successful Lung Volume Reduction Surgery in a Child With Severe Airflow Obstruction and Hyperinflation due to Constrictive Bronchiolitis*. Chest 122: 747-750 [Abstract] [Full Text]
Bellemare, F., Cordeau, M.-P., Couture, J., Lafontaine, E., Leblanc, P., Passerini, L. (2002). Effects of Emphysema and Lung Volume Reduction Surgery on Transdiaphragmatic Pressure and Diaphragm Length*. Chest 121: 1898-1910 [Abstract] [Full Text]
Bloch, K. E., Georgescu, C. L., Russi, E. W., Weder, W. (2002). Gain and subsequent loss of lung function after lung volume reduction surgery in cases of severe emphysema with different morphologic patterns. J. Thorac. Cardiovasc. Surg. 123: 845-854 [Abstract] [Full Text]
Polkey, M. I. (2002). Muscle Metabolism and Exercise Tolerance in COPD*. Chest 121 : 131S-135S [Abstract] [Full Text]
Pompeo, E., Mineo, T. C. (2002). Long-term outcome of staged versus one-stage bilateral thoracoscopic reduction pneumoplasty. Eur. J. Cardiothorac. Surg. 21: 627-633 [Abstract] [Full Text]
Marchand, E., De Leyn, P., Gayan-Ramirez, G., Palecek, F., Verbeken, E., Decramer, M. (2002). Effects of lung volume reduction surgery in hamsters with elastase-induced emphysema. Eur Respir J 19: 422-428 [Abstract] [Full Text]
Fujimoto, T., Teschler, H., Hillejan, L., Zaboura, G., Stamatis, G. (2002). Long-term results of lung volume reduction surgery. Eur. J. Cardiothorac. Surg. 21: 483-488 [Abstract] [Full Text]
MINEO, T. C., POMPEO, E., ROGLIANI, P., DAURI, M., TURANI, F., BOLLERO, P., MAGLIOCCHETTI, N. (2002). Effect of Lung Volume Reduction Surgery for Severe Emphysema on Right Ventricular Function. Am. J. Respir. Crit. Care Med. 165: 489-494 [Abstract] [Full Text]
Hamacher, J., Buchi, S., Georgescu, C.L., Stammberger, U., Thurnheer, R., Bloch, K.E., Weder, W., Russi, E.W. (2002). Improved quality of life after lung volume reduction surgery. Eur Respir J 19: 54-60 [Abstract] [Full Text]
FESSLER, H. E., SCHARF, S. M., PERMUTT, S. (2002). Improvement in Spirometry following Lung Volume Reduction Surgery . Application of a Physiologic Model. Am. J. Respir. Crit. Care Med. 165: 34-40 [Abstract] [Full Text]
Toma, T P, Goldstraw, P, Geddes, D M (2002). Lung volume reduction surgery. Thorax 57: 5-5 [Full Text]
NAKANO, Y., COXSON, H. O., BOSAN, S., ROGERS, R. M., SCIURBA, F. C., KEENAN, R. J., WALLEY, K. R., PARE, P. D., HOGG, J. C. (2001). Core to Rind Distribution of Severe Emphysema Predicts Outcome of Lung Volume Reduction Surgery. Am. J. Respir. Crit. Care Med. 164: 2195-2199 [Abstract] [Full Text]
Kerstjens, H. A M, Groen, H. J, van der Bij, W. (2001). Recent advances: Respiratory medicine. BMJ 323: 1349-1353 [Full Text]
(2001). Managing stable chronic obstructive pulmonary disease. DTB 39: 81-85 [Abstract] [Full Text]
Kotloff, R. M., Hansen-Flaschen, J., Lipson, D. A., Tino, G., Arcasoy, S. M., Alavi, A., Kaiser, L. R. (2001). Apical Perfusion Fraction as a Predictor of Short-term Functional Outcome Following Bilateral Lung Volume Reduction Surgery. Chest 120: 1609-1615 [Abstract] [Full Text]
British Thoracic Society Standards of Care Subcomm, (2001). Pulmonary rehabilitation. Thorax 56: 827-834 [Full Text]
National Emphysema Treatment Trial Research Group, (2001). Patients at High Risk of Death after Lung-Volume-Reduction Surgery. NEJM 345: 1075-1083 [Abstract] [Full Text]
Madani, A., Keyzer, C., Gevenois, P.A. (2001). Quantitative computed tomography assessment of lung structure and function in pulmonary emphysema. Eur Respir J 18: 720-730 [Abstract] [Full Text]
Stirling, G. R., Babidge, W. J., Peacock, M. J., Smith, J. A., Matar, K. S., Snell, G. I., Colville, D. J., Maddern, G. J. (2001). Lung volume reduction surgery in emphysema: a systematic review. Ann. Thorac. Surg. 72: 641-648 [Abstract] [Full Text]
Berger, R. L., Celli, B. R., Meneghetti, A. L., Bagley, P. H., Wright, C. D., Ingenito, E. P., Gray, A., Snider, G. L. (2001). Limitations of randomized clinical trials for evaluating emerging operations: the case of lung volume reduction surgery. Ann. Thorac. Surg. 72: 649-657 [Abstract] [Full Text]
Meyers, B. F., Yusen, R. D., Lefrak, S. S., Cooper, J. D. (2001). Improved long-term survival seen after lung volume reduction surgery compared to continued medical therapy for emphysema. Ann. Thorac. Surg. 71: 2081-2081 [Full Text]
GELB, A. F., McKENNA, R. J. Jr., BRENNER, M., EPSTEIN, J. D., ZAMEL, N. (2001). Lung Function 5 yr after Lung Volume Reduction Surgery for Emphysema. Am. J. Respir. Crit. Care Med. 163: 1562-1566 [Abstract] [Full Text]
Ellis, J R C, Gleeson, F V (2001). Lung cancer screening. Br. J. Radiol. 74: 478-485 [Abstract] [Full Text]
Gelb, A. F., McKenna, R. J. Jr, Brenner, M. (2001). Expanding Knowledge of Lung Volume Reduction. Chest 119: 1300-1303 [Full Text]
PAUWELS, R. A., BUIST, A. S., CALVERLEY, P. M. A., JENKINS, C. R., HURD, S. S. (2001). Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease . NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop Summary. Am. J. Respir. Crit. Care Med. 163: 1256-1276 [Full Text]
(2000). Randomized Trial of Lung Volume Reduction Surgery. JWatch General 2000: 1-1 [Full Text]
Barnes, P. J. (2000). Chronic Obstructive Pulmonary Disease. NEJM 343: 269-280 [Full Text]

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