Authors
Wouter H van Geffen, Felix J Herth, Gaetan Deslee, Dirk-Jan Slebos, Pallav L Shah
Publication date
2017/7
Journal
The Lancet. Respiratory Medicine
Volume
5
Issue
7
Pages
e24-e24
Publisher
ELSEVIER SCI LTD
Description
We thank our colleagues Daniel Franzen and Walter Weder for their interest in our review on lung volume reduction for emphysema, and for sharing their passionate views regarding the role of surgery in treating the disorder. 1 We share their enthusiasm for the surgical approach. However, since the publication of the National Emphysema Treatment Trial (NETT), there has been no substantial research or publications that have encouraged the referral of patients with emphysema for lung volume reduction surgery (LVRS) worldwide. 2 First, the number of surgical lung volume reduction procedures has declined—for example, in the USA, there were 93 LVRS procedures done in 2011, 65 in 2012, and 42 in 2013. 3 Although new surgical techniques have been developed, such as unilateral lobe resection by video-assisted thoracoscopic surgery and non-resection techniques, there has been a scarcity of controlled trials showing their efficacy and superior safety. 4, 5 Franzen and Weder claim excellent safety results in their centre, which we acknowledge, but these results need to be reproduced in multicentre controlled studies to convince the broader medical community and to show that the NETT safety profile is indeed outdated. Franzen and Weder correctly raise the issue of limited long-term data available for BLVR for emphysema. Some ongoing randomised trials are designed to prospectively follow up these patients for 5 years (eg, ClinicalTrials. gov NCT01608490 and NCT01796392). There are already single-centre long-term data published that suggest persistence of benefit and safety for BLVR. 6–8 We agree that a trial that randomly assigns …
Scholar articles
WH van Geffen, FJ Herth, G Deslee, DJ Slebos… - The Lancet. Respiratory Medicine, 2017