13 Sep CELEB Trial: Surgical vs Bronchoscopic Lung Volume Reduction
MedicalResearch.com Interview with:
Ms. Sara Buttery
Research Physiotherapist at Royal Brompton &
Harefield NHS Foundation Trust
University of the West of England
London, England, UK
MedicalResearch.com: What is the background for this study? Would you describe the BVLR technique?
Response: The CELEB trial is a multicentre randomised controlled trial that was carried out at five centres across the UK, with the objective of investigating if Lung volume reduction surgery (LVRS) is significantly superior to Bronchoscopic lung volume reduction (BLVR) in people who are suitable for both procedures.
BLVR is a minimally invasive method of lung volume reduction whereby a fibreoptic camera is passed through the mouth, rather than by an incision in the chest wall as is the case with LVRS. The CELEB trial compared endobronchial valves (EBVs) as a type of BLVR, to LVRS. EBVs are designed to prevent airflow into the treated lobe, but allow air and mucus to exit. EBV treatment can be carried out under general anaesthetic or sedation.
The primary outcome for the CELEB trial was the iBODE index score at 12 months post procedure, as a measure of disease severity.
MedicalResearch.com: What are the main findings?
Response: The CELEB trial found that both treatment arms showed similar improvements in our primary outcome, at 12 months post procedure but concluded that lung volume reduction surgery cannot be considered substantially superior to BLVR in people who are suitable for both procedures.
There was one death in each treatments arm at 12 months post procedure.
MedicalResearch.com: What should readers take away from your report?
Response: That lung volume reduction surgery cannot be considered a substantially superior treatment when compared to LVRS in people who are suitable for both interventions.
When considering the two different treatment options within specialist a LVR multidisciplinary team meeting, in people who are suitable for both interventions, consideration should be given to other differences this study observes in outcomes such as length of stay and postoperative complications and a shared, informed decision made with the patient.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Larger studies are required to add to this evidence base and studies that observe participants in the longer term are required. An economic evaluation is already being carried out and will provide further important information when directly comparing lung volume reduction surgery and Bronchoscopic lung volume reduction, around the relative cost benefit of the two treatments.
I have no disclosures.
European Respiratory Society
Source Reference: Buttery SC, et al “Comparative effect of lung volume reduction surgery for emphysema and bronchoscopic lung volume reduction with valve placement: The CELEB trial” ERS 2022.
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