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Emphysema patients who undergo surgery have a higher chance of dying than patients who choose non-surgical treatment. Although lung-volume-reduction surgery has shown in studies that it may improve lung function and the quality of life, a recent study reveals it may jeopardize emphysema survival rate.

The patients most at risk for death after surgery were those with very low carbon monoxide lowering ability and a low lung volume to begin with. Researchers strongly suggest those high-risk patients to opt for alternative treatments since they are more likely to die after surgery and are unlikely to benefit for the procedure.

A total of 1,033 patients with emphysema participated in the study, which compares lung-volume-reduction surgery with medical treatment. Standard treatments include the prescription of drugs that relax and open air passages in the lungs. Other treatments include cough mixtures, antibiotics, inhalers and exercise. Lung-volume-reduction surgery is an experimental procedure for patients with advanced emphysema.

During surgery, 20 to 35 percent of the bad lung is removed. Studies show that the procedure increases lung function, improves exercise ability and helps in the overall quality of life. However, the risk of lung-volume-reduction surgery has not been thoroughly studied until now.

Researchers found that after 30 days, the death rate for patients who underwent surgery was 16 percent as compared with a rate of 0 percent among the patients who received medical treatment. Compared with the medically treated patients, survivors of surgery had small improvements in lung function and exercise ability but the same quality of life, reported the New England Journal of Medicine (2001;345:1075-1083).