Professor MD Wolfgang Hoffmann
Lung cancer ranks first among the malignant diseases. It is a leading cause of all cancer deaths with survival rate is about 5%. One of the main reasons of extremely high mortality is that lung cancer is mostly diagnosed at the latest stages when it spreads metastases the other parts of body including the liver and brain. Another reason is that lung cancer tends developing in diffused form which is more difficult to cure.
There are two main types of lung cancer and the third one which is quite rare:
The surgery is a main treatment for non-small cell cancer in earlier stages. Often it is accompanied with radiotherapy and chemoterapy. In Clinic of Braunschweig oncology specialists of Cancer Center and the best lung cancer surgeons work together with the other Departments as Cardiothoracic Surgery Department, General Surgery Department and Radiology Department having their main goal in increasing life expectancy and relieving symptoms of lung cancer.
The common surgery procedure for non-small cell lung is removal of one or more lobes (segments) or entire lung. The right lung consists of three lobes, while the left lung has only two lobes. Depending on extent of disease and effected areas you may distinguish the following kind of operations.
Lobectomy is performed to remove malignant tumor localized in the only section (a lobe) of the lung. Sometime a surgeon can remove the two lobes of the right lung.
Segmentectomy or wedge resection. Sometimes, with the small area affected it is possible to prune away only a small segment of the lung. This kind of surgery allows preserving more function of the lung.
Sleeve resection is normally done when cancerous lesion affects a lobe together with a part of the bronchus connected. In this case, the surgeon can remove a segment of the bronchus along with the lobe and to connect healthy part of the bronchus to the remaining lobe.
Pneumonectomy, or removal of the whole lung is required when the entire lung is severely damaged.
Lymph node removal. The lymph node around the lungs also may contain cancer cells. In this case they can be removed. The best technique to perform this procedure is minimally invasive video-assisted surgery (VAT).
Video-assisted surgery also called thoracoscopy is an endoscopic technique which uses small 2-4 cm incisions to bring the tools and small camera inside the chest allowing, thus, to avoid the ribs removal and muscle damage. It results in shorter recovery time, reducing tissues inflammation and infections risk. Using enlarged images allow finding and removing numerous small lesions achieving high preciseness of surgery. According to sources VAT meets better response of immune system, less breathing complications and provide to the patients better quality of life.
The risks of lung surgery depends on the type of surgery and its extent. Such kinds of complications as wound infections and excessive blood loss have greater chances to occur with open surgery. Among the others risks you could name:
Immediately after surgery you will be moved to Intensive Care Unit where you will be under observation of experienced nurses. You will have IV into your arm and drainage system to drain blood and other liquid that may accumulate in the chest cavity after the surgery. Probably, you will need breathing tube and lung ventilation for time being to support your remaining lung.
In a few days you will be moved to the ward and start some moving activity as getting up and sitting in bed and doing some breathing exercises with help of special device, a spirometer. Then, you will able to walk with help but you should keep on moderate activity to avoid complications as blood clots.
You may go home in 7-10 days after surgery.
After lung cancer surgery you may need months for complete restoration of the respiratory function. The shortage of breath is a common complication after partial or total lung removal that lasts for 4-6 months and, then, can go away. If your remaining lung is healthy you may return to your normal activities even if you have the whole lung removed. But if you have any chronicle lung diseases of lung you may be limited in certain activities.
Some people have continuous pain after surgery that can be caused by damage of the nerve during operation. In this case, you may need additional pain relieving therapy. Another pain that has origin from scars decreases over time.