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Lobectomy as a Treatment for Lung Cancer

What Can I Expect If My Doctor Recommends a Lobectomy?

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Updated July 07, 2010

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Lobectomy as a Treatment for Lung Cancer

Lobectomy

A.D.A.M. Medical Encyclopedia

A lobectomy is a type of lung cancer surgery in which one lobe of a lung is removed. (The right lung has 3 lobes, and the left lung has 2 lobes.) A lobectomy is also occasionally performed for other conditions, such as tuberculosis, severe COPD, or trauma that interrupts major blood vessels near the lungs.

Types of Lobectomy

A lobe of your lung can be removed by a few different methods. Your surgeon will recommend one of these based upon both the characteristics of your particular cancer, and how comfortable he is with each of the procedures:
  • Open lobectomy: In an open lobectomy, a lobe of the lungs is removed through a long incision on the side of the chest (thoracotomy).

  • VATS (Video-Assisted Thoracoscopic Surgery) lobectomy: In this procedure, a lobe of the lung is removed through a few small incisions in the chest with the assistance of instruments and a camera. A VATS lobectomy may be considered for stage 1 lung cancer with fairly small tumors (usually less than 3-4 cm). When a VATS lobectomy is possible, it may result in fewer complications than an open lobectomy.

When is a Lobectomy Done?

The type of lung cancer surgery your doctor recommends will depend on several factors, including:
  • The location of your tumor
  • The size of your tumor
  • Whether or not your tumor has spread to nearby tissues
  • Your general state of health
  • How well your lungs are functioning prior to surgery

A lobectomy is most commonly performed for a non-small cell lung cancers in which the tumor is confined to a single lobe. It is less invasive and conserves more lung function that a pneumonectomy, a procedure that involves removing an entire lung.

Preparing for Your Lobectomy

Prior to your lobectomy, your doctor will want to make sure you are as healthy as possible. She will also want to know that you will be able to breathe comfortably after a lobe of your lung is removed. In addition to a careful history and physical and blood tests, breathing tests (pulmonary function tests) will be done to check your lung function prior to surgery. Depending upon your age and physical condition, she may recommend tests to check your heart as well.

Your doctor will carefully review all of your medications during your pre-operative visit, and may recommend stopping some of your medicines for a period of time prior to surgery. It is helpful if you bring along the bottles containing any prescription and non-prescription medications, as well as any supplements, including vitamins, that you use.

If you smoke, she will strongly recommend that you quit as soon as possible. Quitting smoking before surgery can reduce your risk of complications and increases the chance that your surgery will be successful.

During Your Lobectomy - The Lobectomy Procedure

A lobectomy is performed in the operating after you are given a general anesthetic. There are two major procedures that are often done to remove a lobe of the lung. In an open lobectomy, a lobe of the lung is removed through a long incision along the side of the chest. In a VATS lobectomy, a lobe is removed with the use of a camera and special instruments through several smaller incisions in the chest. Before closing the incision(s), the surgeon will insert a chest tube into the surgical area to allow excess fluid and air to drain outside of the chest for a period of time.

After Your Lobectomy - Lobectomy Recovery

Following your lobectomy, you will be monitored in the intensive care unit (ICU) for a day or so before going to a regular hospital room. A respiratory therapist will work with you, asking you to take deep breaths and breathe into an incentive spirometer. The nursing staff will help you get up and move about as soon as you are able. Barring complications, most people stay in the hospital between 4 and 7 days, depending on the type of lobectomy that was done.

Lobectomy Complications

A lobectomy is a major surgical procedure, and complications are not uncommon. Your doctor will discuss these with you prior to surgery. Some potential complications may include:
  • Infections, such as pneumonia
  • Bleeding
  • Heart problems, such as a heart attack or irregular heart rhythms
  • A persistent air leak, requiring the chest tube to be left in place longer than 3-4 days
  • Blood clots in the legs (DVTs) or traveling to the lungs (pulmonary embolus)

Lobectomy Prognosis

The prognosis following a lobectomy depends on many different factors. Some of these include the stage of your lung cancer -- that is, how far it has spread -- as well as your general health and whether you have any other lung problems in addition to lung cancer.

When a lobectomy is successfully done for early stage lung cancer, it offers a chance for long-term survival without recurrence of the cancer.

Lobectomy In-Depth

Sources:

American Cancer Society. Detailed Guide: Lung Cancer – Non-Small Cell. Surgery. Updated 10/20/09. http://ww3.cancer.org/docroot/CRI/content/CRI_2_4_4x_Surgery_15.asp?sitearea=

Erhunmwunsee, L. and M. Onaitis. Smoking cessation and the success of lung cancer surgery. Current Oncology Reports. 2009. 11(4):269-74.

Sawada, S. et al. Comparison in prognosis after VATS lobectomy and open lobectomy for stage I lung cancer. Surgical Endoscopy. 2007. 21(9):1607-11.

Whitson, B. et al. Surgery for early-stage non-small cell lung cancer: a systematic review of the video-assisted thoracoscopy surgery versus thoracotomy applications to lobectomy. Annals of Thoracic Surgery. 2008. 86(6):2008-16.

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