The latest results from the landmark National Emphysema Treatment Trial (NETT) confirm and extend earlier findings that selected patients with advanced emphysema predominately in the upper area of the lung may benefit from surgery and the benefits are still apparent with two more years of follow-up. The newly published findings from the largest study of bilateral lung volume reduction surgery (LVRS) to treat severe emphysema also confirm that patients with upper-lobe emphysema and poor exercise capacity before surgery are more likely to have improved survival compared to similar patients treated with medical therapy without surgery. Surgery might also provide some symptom relief in patients with emphysema in the upper lung area but who had good exercise capacity prior to surgery; however, survival rates did not improve in this group.
NETT researchers describe the effects of LVRS after following 1218 patients for an average of 4.3 years, two years longer than the primary results reported in 2003. The earlier findings led to Medicare coverage of LVRS for patients meeting criteria based on the study results. NETT began in 1996 as a cooperative effort between the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health and the Centers for Medicare & Medicaid Services. Both are agencies of the U.S. Department of Health and Human Services.
"Long-Term Follow-Up of Patients Receiving Lung-Volume-Reduction Surgery Versus Medical Therapy for Severe Emphysema" is published in the August issue of the Annals of Thoracic Surgery.
Gail Weinmann, M.D., director of the NHLBI Airway Biology and Disease Program, is available to comment on the study's findings.
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Chronic Obstructive Pulmonary Disease
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