Study Sheds Light on Emphysema Surgery

An article published this week says a new study of emphysema patients at Chapman Medical Center may be the first step toward federal approval for a controversial treatment that the federal government banned for Medicare coverage last year.

The study, published in the American Journal of Respiratory and Critical Care Medicine, explains why some emphysema patients breathe more easily after lung reduction surgery.

“Up until this time, we’ve known that this procedure works for selected patients with emphysema, but we didn’t know why it works,” said Dr. Arthur F. Gelb, a clinical professor of medicine at the UCLA School of Medicine, who worked on the study with several doctors and wrote the article.

“This is the first article that actually explains why the surgery works,” Gelb said.

Federal agencies must be convinced that surgical procedures are safe and effective before approving Medicare coverage.

When officials withdrew support for lung reduction surgeries last December, hundreds of patients at Chapman, UC Irvine and UCLA were no longer eligible for the treatment.

The American Lung Assn. estimates that about 2 million Americans suffer from emphysema, a progressive disease that restricts the patient’s ability to breathe.

The surgery involves removing the most diseased parts of the lung by various methods, allowing the remaining lung tissue to work more efficiently.

The surgery, the article explained, improves the elastic recoil of the lungs so they can expand and contract, Gelb said.

The study is just the first step toward governmental approval. A national study to begin in the spring under the direction of the National Institutes of Health will provide more research by which to judge the effectiveness of the surgery.

“This is another notch in the belt,” Gelb said of the steps to federal approval.