Lung Volume Reductions Surgery (LVRS) Study

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00018525
Recruitment Status : Completed
First Posted : July 5, 2001
Last Update Posted : January 21, 2009
Information provided by:
VA Office of Research and Development

Brief Summary:
The main objectives of this study are to see if a type of lung surgery, known as lung reduction surgery, in addition to standard medical treatment improves the quality of life, lung function, and reduces the high mortality associated with severe emphysema when compared to standard medical treatment alone. Another goal of this study is to better identify the patients most likely to benefit from this surgical treatment. The information obtained in this study is important because lung reduction surgery is being done in several centers around the country but its long term benefits, if any, over standard medical treatment, are not known.

Condition or disease Intervention/treatment Phase
Emphysema Procedure: Lung Volume Reduction Surgery Not Applicable

Detailed Description:

Chronic obstructive pulmonary disease is a major cause of mortality and morbidity in the US. Although medical therapy may delay disability and death, there has been no definitive therapy to improve pulmonary function in these patients. The resection of emphysematous lung parenchyma, lung volume reduction surgery (LVRS), has been reported in uncontrolled studies in highly selected emphysema patients to substantially improve parameters of pulmonary function, dyspnea, and quality of life. Numerous case series have reported significant short-term benefits. Current LVRS data regarding outcomes is limited by study design lacking parallel control groups and lack of long term data.

The main objectives of this proposal are: 1) To study the effects of LVRS in addition to maximal medical therapy when compared to maximal medical therapy alone in terms of improvement of physiology and quality of life. 2) To better define preoperative selection criteria to determine which patients would benefit from this surgical intervention. To accomplish these objectives, patients who meet clinical criteria and complete a pulmonary rehabilitation-program will be randomized into 2 groups: 1) Continuing optimal medical care or 2) bilateral LVRS via median sternotomy in addition to medical therapy.

The Houston Veterans Affairs Medical Center is currently performing LVRS under a protocol supported by Merit Review funding (1996-200O, Effects of lung volume reduction surgery in the treatment of severe emphysema) in selected patients with severe emphysema. This controlled study is designed to determine patient selection criteria, as well as, both the short and long term benefits of operated and non-operated patients with severe emphysema receiving maximal medical therapy. Given the strict selection criteria and unexpectedly high survival in both treatment groups to date, it is unlikely in a study of this size that survival differences will be detected.

In 1997 the National Heart, Lung, and Blood Institute and Health Care Financing Administration organized a national registry and a controlled, multicenter clinical trial to compare bilateral LVRS to maximal medical treatment (NETT, National Emphysema Treatment Trial).

Both our on-going LVRS study and the NETT have been hindered by an underestimation of the difficulty in recruiting patients who qualify for this invasive study. Both studies have evaluated/recruited to date approximately 50% of the projected number of subjects required to achieve statistical power to draw significant clinical conclusions. In fact, the NIH is investing additional funds in the national "marketing" of the NETT and LVRS. We believe that this national marketing effort, as well as changes and enhancement of local recruiting strategies will allow us to enroll adequate patients for study completion. This controlled clinical trial will provide data to address crucial clinical and potential economic implications of this surgical intervention in patients with severe emphysema.

Study Type : Interventional  (Clinical Trial)
Allocation: Randomized
Primary Purpose: Treatment
Official Title: Effects of Lung Volume Reduction Surgery in the Treatment of Severe Emphysema
Study Start Date : October 2000
Study Completion Date : September 2002

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Emphysema

Information from the National Library of Medicine

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Ages Eligible for Study:   up to 75 Years   (Child, Adult, Older Adult)
Sexes Eligible for Study:   Male
Accepts Healthy Volunteers:   No
  1. Post-bronchodilator FEV I < 40% and > 15% of predicted
  2. TLC > 120% of predicted*
  3. Carbon monoxide diffusing capacity by the single breath technique (DLCOSB) < 50% of predicted
  4. PaCO2 < 55 mmHg
  5. Age 75 years or younger

    • TLC will be determined by body plethysmography using slow inspiratory effort to determine thoracic gas lume because of the overestimation of lung volumes by high frequency panting in patients with COPD.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00018525

United States, Texas
Veterans Affairs Medical Center
Houston, Texas, United States, 77030
Sponsors and Collaborators
VA Office of Research and Development Identifier: NCT00018525     History of Changes
Other Study ID Numbers: SURG-014-00S
First Posted: July 5, 2001    Key Record Dates
Last Update Posted: January 21, 2009
Last Verified: December 2004

Additional relevant MeSH terms:
Pulmonary Emphysema
Pathologic Processes
Pulmonary Disease, Chronic Obstructive
Lung Diseases, Obstructive
Lung Diseases
Respiratory Tract Diseases