When lung volume reduction surgery (LVRS) was developed more than a decade ago, it was hailed as a revolutionary treatment for people suffering from emphysema. Today, LVRS is "better than ever" in improving lung function and quality of life in those patients who are appropriate candidates for the surgery, according to Bryan Meyers, MD, Washington University thoracic surgeon at Barnes-Jewish Hospital and surgical director of the LVRS program.
LVRS was developed by a team of Washington University physicians in 1993. This innovative procedure involved physicians removing 20 to 30 percent of a patient''s lung tissue most damaged by emphysema, allowing the remaining tissue more room to expand. Though the procedure did not cure for the disease, patients receiving lung volume reduction surgery had a measurable increase in lung function and reported a much improved quality of life.
As more physicians and emphysema patients learned about LVRS, people from across the U.S. came to Barnes-Jewish to be evaluated and to undergo the procedure. Today, more than 400 patients have had LVRS at Barnes-Jewish, and the program remains one of the strongest in the world because of its unmatched experience and ability to provide a full spectrum of care, Dr. Meyers said.
"For instance," he said, "the pulmonologists, Dr. Stephen Lefrak and Dr. Roger Yusen, have been with the program since day one."
The LVRS program provides medical management of emphysema and its complications, pulmonary rehabilitation services, counseling and assistance with financial issues and patient education, along with the surgery itself.
Another key component is having anesthesiologists who are experienced in working with the challenges of emphysema patients, Dr. Meyers said. "Our anesthesiologists are familiar with the problems emphysema can cause because they also work with our lung transplant program. There''s a synergy between lung transplant and lung volume reduction surgery."
The Washington University and Barnes-Jewish Hospital lung transplant program has long been considered the premier program in the world, and patients with emphysema often come here for a dual evaluation – for LVRS, as well as lung transplant, to see which procedure would best treat the patient''s condition. And patient evaluation is the key to the success of LVRS, Dr. Meyers.
Patients who will benefit most from the procedure usually have:
-
symptomatic emphysema,
-
diseased tissue in specific "target" areas of the lungs that can be safely removed surgically,
-
enough good lung tissue left to support the patient''s breathing after the damaged tissue is removed,
-
no other severe conditions or "co-morbidities" that play a larger role in the patient''s health than the emphysema or that would make the surgery more dangerous or less effective.
When the appropriate patient undergoes LVRS, the benefits can be great, Dr. Meyers said.
"Across the board, patients report an improved quality of life," he said. "They usually have an increased capacity for exercise, as measured by the distance they cover during a six-minute walk. And they have a measurable increase in lung function."
For more information, or to schedule an appoint for LVRS evaluation, call 314-TOP-DOCS (314-867-3627) or toll-free at 866-867-3627.