Division of Thoracic Surgery, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
Division of Thoracic Surgery, McMaster University, St. Joseph's Healthcare, Hamilton, Ontario, Canada.
Ann Thorac Surg. 2013 Oct;96(4):1217-1222. doi: 10.1016/j.athoracsur.2013.04.077. Epub 2013 Jul 26.
The Canadian Lung Volume Reduction Surgery (CLVRS) trial was a multicentered randomized controlled trial that concluded that lung volume reduction surgery improves functional status and health-related quality of life (for at least 2 years) in selected patients with advanced emphysema.
This retrospective observational study assessed the long-term survival of patients enrolled in the CLVRS at 8 to 10 years after randomization. Vital statistics were gathered through telephone contact, physician records, and municipal obituaries. Survival analysis was undertaken using Kaplan-Meier and the Cox proportional hazards models.
Fifty-two patients (84% of the initial 62 patients randomized) had a median survival time of 4.11 years. A 16-month survival advantage and a 20% reduction in mortality was observed in the LVRS group as compared with the best medical care group. Although clinically meaningful, these differences were not statistically significant.
These findings echo those of other published reports and demonstrate the potential long-term benefit of LVRS in the treatment of end-stage emphysema.
加拿大肺容积减少手术（CLVRS）试验是一项多中心随机对照试验，该试验得出的结论是，肺容积减少手术可改善晚期肺气肿患者的功能状态和健康相关生活质量（至少持续 2 年）。
本回顾性观察研究评估了在随机分组后 8 至 10 年后参加 CLVRS 的患者的长期生存情况。通过电话联系、医生记录和市讣告收集生命统计数据。采用 Kaplan-Meier 和 Cox 比例风险模型进行生存分析。
52 名患者（随机分组的 62 名患者中的 84%）的中位生存时间为 4.11 年。与最佳药物治疗组相比，LVRS 组的 16 个月生存率优势和 20%的死亡率降低得到了观察。尽管具有临床意义，但这些差异没有统计学意义。
这些发现与其他已发表的报告相呼应，证明了 LVRS 在治疗晚期肺气肿方面具有潜在的长期益处。
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