Herald news services
BOSTON — An increasingly common operation for emphysema that involves cutting away part of the lungs is dangerous — and even deadly — for many patients in advanced stages of the disease, researchers say.
Sixteen percent of the very ill patients who had the surgery were dead within a month, according to the latest findings from an ongoing national study of the procedure coordinated by the National Institutes of Health.
Researchers immediately halted more surgery on patients with the same characteristics of advanced illness. The investigators will publish the findings Oct. 11 in The New England Journal of Medicine but released them Tuesday to alert doctors and patients immediately.
The procedure, called lung volume reduction surgery, has stirred much excitement over the last five years, and some studies have suggested it can give at least a reprieve to many patients. The surgery appears to work by increasing the elastic properties of the chest, allowing emphysema sufferers to move more air in and out of their lungs.
The operation is expensive — about $30,000 — and can result in long and expensive hospital stays. Medicare stopped paying for it in 1995, saying there was no firm evidence the procedure worked.
However, the program agreed to help pay for the large national study, to be co-sponsored by the National Institutes of Health, in which 1,800 patients would be randomly assigned to undergo surgery, or to get an alternative treatment consisting largely of drugs and exercise. Medicare said it would pay for the operation only for people who were in the study.
A pioneer in the surgery, Dr. Joel Cooper, said administrators at the federal Medicare program for the elderly, which is funding the study, are seeking justification to limit, delay or deny coverage for the surgery.
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