Lung Reduction Surgery

A recent option for sufferers of severe emphysema is Lung Reduction Surgery. While this procedure is not yet covered by all insurance programs, including Medicare, it offers hope for some emphysema patients, and can offer benefits not available in other places.

Lung reduction surgery is a procedure in which the diseased portion of the lung is cut away, leaving only healthy lung tissue. While, on the surface, this would seem to reduce the lung volume, it actually allows for more expansion of the lungs, and therefore improved breathing. A recent article in the New England Journal of Medicine indicated that researchers as the University of Pittsburgh studied lung elasticity in 16 patients and found that the lung recoil, the ability of the lungs to spring back after each breath, was increased. Their study indicated that the increased recoil allowed the patients to walk further in a test than those who did not have the treatment.

Lung reduction surgery was developed in the 1950's and was seen as an alternative to lung transplantation or other techniques which were being used or at least experimented with at that time. Since the number of donor lungs was limited, Dr. Otto C. Brantigan of he University of Maryland developed the technique which became known as lung reduction surgery. Initial tests showed that while the treatment worked in a majority of cases, problems with air leakage from the affected lung developed, as well as relatively high short-term mortality rates and as a result, alternative methods of surgery were developed.

One of the new techniques is to use a strip of tissue, such as from the heart of a cow or a synthetic material, to prevent air leaks from the surgical site. This overcomes the leakage problem and improved surgical and medical care techniques has reduced the incidence of mortality, so that it is comparable to other types of major surgery.

Currently, there is a study being done at the National Heart, Lung and Blood Institute at seventeen centers around the United States. Called the National Emphysema Treatment Trial (NETT), it seeks to find candidates for the surgery and track their progress following the operation. If you think you may be a candidate for the NETT, visit the list of centers at the Web site of the National Heart, Lung and Blood Institute.

"It may be that there is a subgroup of people with emphysema who benefit greatly from the procedure. And there also may be a subgroup of patients who will not improve and therefore should not be subjected to the risks. Identifying such groups is one of the goals of the study," says James P. Utz, M.D., the lead pulmonologist for the Mayo Clinic's NETT center.

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