What is a Pneumonectomy?

Emma Lloyd

The most common types of lung surgery include lobectomy and wedge resection, both of which involve the removal of a portion of one lung. In some cases, however, removing only a small section of the lung is not enough to eradicate lung disease. Pneumonectomy surgery involves the complete removal of one lung, and is most often carried out when lung cancer is too far advanced for partial removal to be effective. Pneumonectomy was once used as a treatment for tuberculosis, but complete lung removal is now almost exclusively a treatment for lung cancer and mesothelioma.

The human respiratory system, showing the trachea and lungs.
The human respiratory system, showing the trachea and lungs.

To be a good candidate for this surgery, a patient must meet several requirements. The first requirement is that their cancer must be confined to the lung which is being removed. If the cancer has spread to another part of the body, removing the lung will not eradicate the disease. In addition, it is important that people who undergo the surgery be otherwise as healthy as possible, due to the physical demands that surgery and recovery place on the patient.

Following a pneumonectomy, patients will be given a spirometer to improve lung function post-surgery.
Following a pneumonectomy, patients will be given a spirometer to improve lung function post-surgery.

During the procedure, the patient is under general anesthetic. After making an incision in the chest, the surgeon may remove one or more ribs to facilitate lung removal. Next the lung is collapsed and removed, after which blood vessels are clamped and sutured. Once the lung is removed, the incision is closed.

Pneumonectomy most commonly involves removal of one lung. In some cases, however, an extrapleural pneumonectomy must be performed. In this surgery, the lung is removed, as well as a portion of the membrane which lines the lung, and part of the diaphragm. This surgery is usually carried out in cases of advanced malignant mesothelioma, due to the aggressive manner in which this type of cancer spreads in the body.

Most patients will stay in the hospital for approximately two weeks. This is necessary not only because of the physical demands of surgery, but also because of the severity of possible pneumonectomy complications. People who undergo the surgery are at risk of heart attack, as well as pneumonia and other serious infections. In addition there is a risk of pulmonary embolism, resulting from blockage of the pulmonary artery. The immediate risk of these complications decreases after several weeks, and once their hospital stay is over, patients continue to recover at home for two or three months.

With a marked reduction in lung capacity and respiratory function, many people who undergo pneumonectomy have difficulty adjusting. To help compensate for this patients are evaluated before the surgery to try and predict how well their remaining lung will function. Most patients are given equipment such as an incentive spirometer so that they can perform exercises to improve lung function post-surgery.

The incentive spirometer is a device which the patient must breathe through very slowly. The device is fitted with a gauge which represents the patient’s lung capacity and function. By carrying out several repetitions of the exercise per day, patients can improve their lung function. The spirometer is particularly useful in this regard because it provides patients with an easy way of monitoring their own progress.

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