P&S Journal: Spring 1997, Vol.17, No.2
Trials Begin for Lung-Reduction Surgery
Columbia-Presbyterian, in a consortium with Long Island Jewish Medical Center, is participating in the first multi-center clinical trial of lung volume reduction surgery (LVRS) for patients with advanced emphysema. First performed in the 1950s, LVRS was reintroduced in 1994 after it was improved through surgical innovations and overall medical advances in anesthesia, perioperative care, and pain control. A number of centers have performed the surgery, and early data have been promising despite the potential major risks of the surgery and questions about its efficacy.
The seven-year clinical trial is designed to determine the safety and efficacy of the surgery before it is used more widely. The research is the first collaboration of this magnitude for the NIH (through the National Heart, Lung, and Blood Institute) and the Health Care Financing Administration. If the study demonstrates significant benefit in regard to cost, the surgery will be covered by Medicare.
LVRS has shown promising results in scattered clinical trials, says Dr. Byron M. Thomashow, associate clinical professor of medicine at P&S. Surgeons at CPMC have performed 109 of these surgeries. "About 80 percent of our patients have experienced significant improvement."
About 250 patients will be enrolled in the randomized trial at CPMC/LIJ, and all surgery will be performed at CPMC. Principal investigators for the consortium will be Dr. Mark Ginsburg, assistant clinical professor of surgery at P&S, and Dr. Steven Scharf, head of pulmonary research in pulmonary and critical care medicine at Long Island Jewish Medical Center and professor of medicine at Albert Einstein.