The lungs are vital organs of human body carrying out a function of respiration, or supplying the body with oxygen. Hereupon, any serious disorder of the lungs can become life threatening. Though the most of lung diseases can be treated with conservative methods, there are some conditions when you may need surgery. As a rule, lung surgery is performed by thoracic surgeons but sometimes other specialists also involved.
When You Need Lung Surgery?
Among the lung problems there are a few that can be indication having lung surgery, as:
- Lung mass
- Fluid around the lung
- Lung collapse
- Complications of tuberculosis
- Lung cancer
Lung surgery can be diagnostic to confirm the diagnosis or take a probe for biopsy or curing to remove diseased segment of the lung.
Types of Lung Surgery
Based on extent of lung surgery it is possible to divide lung operations as following:
- Lobectomy, which is removal of a lobe which is one of sections of the lung
- Wedge resection, or cutting a small portion of the lobe
- Segmentectomy, which is removal of a larger part of the lobe
- Pneumonectomy, which is a procedure to remove entire lung
- Lung transplantation
- Surgery to remove fluid or blood from and around the lungs
- Surgery to remove lung infections
- Surgery to remove pulmonary blebs, small air filled pockets that can lead to pneumothorax (collapsed lung)
- Surgery to remove lung cancer
- Surgery to remove benign tumors of the lungs
Depending on method used to perform the surgery you can distinct the following types:
- Thoracotomy is open surgery which is done through a large incision in the chest. The second one is minimally invasive technique that uses smaller incisions to get into the thorax.
- Thoracoscopy. Minimally invasive lung surgery is done with help of thorascope, a special optical tube inserted via “keyhole” cut to explore the situation inside the thorax. Another incision is used to bring surgical tools to the site of surgery. A surgeon can observe what happens in the chest cavity on display and operate accordingly to the images. Thorascopy can be used as independent treatment or as diagnostics mean before open surgery.
- Lung Resection. Lung resection including lobectomy and total surgical removal of the lung is the most common type of lung surgery. It can be required both for cancerous and non-cancerous lung diseases.
When you are recommended to have removal of a part or entire lung you may feel uncomfortable or confused and that can be the reason to have additional consultation with some other specialists. In Clinic of Braunschweig many specialists as general physicians, bronchial diseases specialists, thoracic and general surgeons, radiologists and oncologists take part in examination and making decision whether you are a candidate for lung removal. We advise surgical removal only when it is absolutely necessary.
Before operation you will have routine examination as:
- Blood and urine tests
- X-Rays examination
- CT scan
- Cardiopulmonary function test
You should not smoke a few weeks before the surgery and may be advised to stop using certain kinds of medications increasing the risks of bleeding, such as aspirin, ibuprofen, vitamin E and some others. You also will have a consultation with your anesthesiologist prior to surgery. Starting from midnight before your surgery you should not eat and drink.
Total Lung Removal Surgery Process
The procedure is done under general anesthesia. Open chest surgery can take from 2 to 6 hours depending on complexity and type of surgery.
First, a surgeon makes a long incision on the side where your diseased lung is. The ribs can be removed for better view. Then, the lung is collapsed and all the blood vessels as well the bronchus are clamped. After that, it is possible to remove the lung through the incision.
Then, the surgeon checks all the cut vessels and tubes to avoid blood leaking and drainage is inserted. Finishing the procedure the surgeon closes the chest and carefully sews a wound.
Risks and Complications of Lung Removal
The mortality rate after pneumonectomy is two times higher than after lobectomy, or partial removal of the lung. It significantly differs for various diagnoses, so it is difficult to determine exact rate for 30-days survival. In case with cancer of lung, it can differ depending on disease stage. Immediate survival rate is as high as 96-98% for the left lung and 88-90% for the right lung.
Among the factors increasing the risk of surgery are:
- Older age
Possible complications of lung surgery are:
- Excessive bleeding
- Air leakage
- Breath shortage