Lung cancer is the rapid growth of
abnormal cells in the lung tissue. Surgery to remove all or part of a lung may be done by making a cut on one side of your chest (thorax) during a procedure called a thoracotomy. Surgery that uses this approach avoids areas in the chest that contain the heart and the spinal cord.
After the cut is made
between the ribs, all or part of the lung is removed depending on the location,
size, and type of lung cancer that is present.
Wedge resection (segmentectomy). The
surgeon removes a small wedge-shaped piece of lung that contains the lung
cancer and a margin of healthy tissue around the cancer. This is likely to be
done when your lung function would be decreased too much by removing a lobe of
lung (lobectomy). The risk of lung cancer coming back (recurring) is higher
with this method.
Lobectomy. The right lung has three lobes and the
left lung has two lobes. A lobectomy removes the entire lobe of your lung that
contains the cancer. Your lungs can function with the lobes that
Pneumonectomy. A pneumonectomy removes your entire lung
that contains the lung cancer. A pneumonectomy is done only when needed,
because it will greatly reduce your overall lung function.
Sleeve resection. The surgeon removes the cancerous part of the bronchus and reconnects the healthy ends. The bronchus is the part of the trachea (windpipe) that branches off into each side of the lungs.
A chest tube is used after
lung surgery to drain fluid and blood out of your chest cavity and help your
lung refill with air.
A video-assisted thoracoscopic surgery (VATS) may be done
before or instead of a thoracotomy. This procedure involves inserting a long,
thin tube (videoscope) with a camera attached and small surgical instruments
into your chest through small cuts made between your ribs.
What To Expect After Surgery
Lung surgery requires you to stay in the
hospital after the procedure. How long you stay will depend on:
Your remaining lung function.
overall health before surgery.
Which type of surgery was
Pain is a common concern after this surgery. Depending on the type of surgery you have, your chest area may be painful for several weeks to months after surgery. Your doctor will prescribe pain medicines you can use for pain after the surgery. You can also talk to your doctor about things you can do at home to help ease pain.
One or more chest tubes are used after
surgery to drain your chest cavity of fluid and blood, which are present after
lung surgery. The chest tubes also help your lungs refill with air. Chest tubes
are placed in your chest cavity and extend out through your chest wall and skin
through small cuts between your ribs on the same side as the surgery. The tubes
are connected to a machine that creates a gentle suction, which helps your
chest fluid to drain. The fluid is collected in a container that measures the
amount of fluid draining from your chest. The chest tubes will be removed when
the drainage from your chest has stopped and no air is leaking from your chest
incision, which is usually after a few days.
A respiratory therapist
will help you with breathing treatments to improve your lung function after
surgery. Treatments usually involve deep breathing and the use of a spirometer. Medicines may also be used to help open
your airway and help you breathe more easily.
Why It Is Done
A thoracotomy may be done to:
Confirm the diagnosis of lung
Remove a lung cancer.
Remove scar tissue or fix
an air leak in your lung.
VATS may be done to:
Confirm the diagnosis of lung
lymph nodes in the center part of your chest
Do a wedge resection of your lung cancer. This
removes the cancer and the lung tissue surrounding the
Remove the segment (lobe) of the lung that contains the
How Well It Works
Surgery is more effective in
non-small cell lung cancer when the lung cancer can be
completely removed and the cancer has not spread to lymph nodes or outside the
Surgery is sometimes used in
limited-stage small cell lung cancer, when there is a single tumor and the cancer has not spread to the lymph nodes. But small
cell lung cancers are not often diagnosed at this early
Studies done in medical centers that do many VATS procedures have shown that this type of surgery works as well as open-chest surgery (thoracotomy) for cancer treatment.footnote 1 People who had VATS also had less pain, a shorter hospital stay, and a faster recovery.
Lung surgery risks include:
air leak in your lung that does not close.
Damage to your heart,
lungs, blood vessels, or nerves in your chest.
Lung surgery is most effective for
early-stage lung cancers, especially non-small cell lung cancer.
Lung function tests, possibly including
a lung scan, are usually done before surgery is considered. You may not be a
good candidate for surgery to remove all or part of a lung if you have poor
lung function. Cardiac studies may also be done if you
have any risk factors for complications from heart problems.
surgery may be done to confirm a diagnosis of lung cancer. Additional surgery,
such as removing the affected lobe (lobectomy) or
lymph node biopsies, may be done at the same time for
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