Lung resection is the surgical removal of all or part of the lung, because of lung cancer or other lung disease.
Surgery can provide a cure in some cancer cases, when the tumour is discovered early. Your physician will recommend one of the following types of resection, depending on your diagnosis. If you have cancer, the type of resection will be based on the tumour location, size, and type, as well as your overall health and lung function prior to surgery. On the right side, the lung has three anatomical parts (called lobes) and on the left there are two parts (lobes). Usually, an operation for cancer involves removing a lobe, which is called a lobectomy.
The type of lung resection used will depend on the location and size of your tumor, and also the ability of your remaining lung tissue to compensate for your breathing after surgery.
- Wedge resection, or segmentectomy. These terms refer to the removal of an area of lung smaller than a lobe, usually the tumour and a small area of healthy lung tissue around it. This is a treatment used for early-stage cancer and sometimes to remove a piece of lung where cancer is suspected but not proven. It is also used to remove cancer that has spread to the lung through the bloodstream from other parts of the body.
- Lobectomy. In a lobectomy, the surgeon removes a lobe of the lung. This is the usual operation performed for lung cancer, as this has the best chance of removing all the cancerous tissue and decreasing the chance of cancer coming back
- Pneumonectomy is the removal of an entire lung. This option is considered if a tumor is especially large, or in a difficult-to-reach or central position in the lung. Although pneumonectomy can result in significant loss of function, many people live quite well with only one lung
What to expect
It is standard procedure that you are asked to sign a consent form before anything is done to your body. Dr Orr will explain how the procedure is done, what will be its benefits, what the risks are and why is it needed.
You are asked to inform Dr Orr if you:
- Have taken any medicines, which includes blood thinners (anti-coagulants) e.g. aspirin, warfarin (Coumadin) or clopidogrel (Plavix)
- Have asthma or emphysema
- Are allergic to any medicines and anaesthetics
- Have bleeding problems
- Are pregnant
In preparation for the procedure, Dr Orr will ensure you undergo certain laboratory tests such as complete blood count (CBC), electrolytes and clotting factors. You will also need to have lung function tests to check you lung capacity prior to the surgery. You will have a pre-admission appointment one to two weeks beforehand, in which you will have routine blood testing and consultation with the anaesthesiologist. You will be advised at what time before the biopsy that you should stop taking any solid foods or fluids. Usually, it is 6 hours before the procedure. If you are taking regular medication and they are to be continued on the day of your surgery, you can take them using with a sip of water.
Smoking cessation must occur at least two to three weeks prior to surgery to be effective. Surgery will not be performed if you are still smoking. You should permanently quit smoking in order to reduce your risk of further cancer and ensure that your remaining lung works effectively.
On the day before your procedure, you should receive a call from the hospital. You will be given information about the following day, including where to go and when to arrive. When you arrive, you will be taken to a pre-surgery area so that a nurse can take your temperature, blood pressure, pulse, and listen to your heart and lungs. An intravenous (IV) line will then be placed in your arm, so that medications may be administered before, during, and after the procedure.
Your surgery may take 2-3 hours. Your family may wait in the family waiting room.
After surgery, you will be taken to the Post Anaesthesia Recovery Unit and monitored for any changes in blood pressure, heart rate, and oxygen saturations. An IV line will remain in your arm to keep you hydrated and to administer pain medication, as necessary. You may also require the use of a ventilator to ensure air exchange and to prevent pneumonia for a period after surgery. You will have some chest drainage tubes that remain in your chest at the end of the procedure to drain any fluid or air from the chest cavity. These usually remain in place for 3-5 days or longer if there is some air leaking from the lungs. The usual hospital stay is about one week.
Before you go home, your nurse will teach you how to use any equipment you might need, how to care for your incision, and review your medications with you. Gradually, over the course of a few weeks, you will regain your strength and be able to return to normal activities. Be sure to call your doctor if you notice any of the following:
- High temperature
- Coughing up yellow, green, or bloody mucus
- Allergic reaction, such as redness, swelling, trouble breathing
- Increased pain
Always take your medicine exactly as prescribed. Call Dr Orr if you have any questions or changes.