Lung lobectomy

Lobectomy of the lung is a surgical operation where a lobe of the lung is removed.[1] It is done to remove a portion of diseased lung, such as early stage lung cancer.[2]

Lobectomy (lung)
ICD-9-CM32.49

Administration

The most common type of lobectomy is known as a thoracotomy. When this type of surgery is done the chest is opened up. An incision will be made on the side of the chest where the affected area of the lung is located. The incision will be in between the two ribs located in that area. The surgeon will then be able to have access to the chest cavity once the two involved ribs have been pried open. The surgeon will then be able to remove the lobe where the problem is contained.[3] Another less invasive lobectomy procedure can be performed through a video assisted surgery, where the surgeon does not need to pry the two ribs open in order to get access. A few small incisions are made and surgical tools are inserted into the chest cavity aided by a small video camera. The video images will be projected onto a screen that the surgeon can see. Once the problem area is located the small tools that were previously inserted will be utilized to perform the surgery.[3] Once the surgery is complete, the patient will remain in the intensive care unit of the hospital for a day. They will then remain in a regular hospital room for about 4 to 7 days.[4]

Risks

As with any surgery, complications may occur. Post lobectomy air leak is a significant clinical problem,[5] and patients undergoing pulmonary resections often present with postoperative air leaks.[6] Other risk factors include infections, reactions to anesthesia, bleeding, pneumothorax and bronchopleural fistula.[7] New methods for sealing tissue are evaluated in research studies, aimed to determine their efficacies in preventing air leakages.[8]

The main infection that a patient runs the risk of is pneumonia. Pneumothorax occurs when there is air trapped between the lung and the chest wall; this can leave the patient's lung unable to fully inflate ("collapsed lung"). A bronchopleural fistula is when there is a tube-like opening that allows air to escape.[9] Minimally invasive surgery is beneficial for patient outcome, with reduced risk of complications.[10]

Post-surgery

Once the surgery is complete, the patient will remain in the intensive care unit of the hospital for a day. They will then remain in a regular hospital room for about 4 to 7 days.[4] After the patient returns home they typically remain in recovery for about four to six weeks, although some patients may be able to return to work and normal activities sooner. Pain is very common amongst patients for quite some time after a lobectomy and doctors will usually prescribe pain medication to help with this.[11] Chest tubes are left inside the patient in order to help excess fluid drain and are removed after a few days. Before removal, doctors must ensure that there is no air or fluid leaking from them.[11] In addition to this, follow-up appointments will be scheduled with the patient's doctor. X-rays will be taken of the patient's lung to make sure everything is healing properly. Patients that have had a lobectomy with no major risks shall recover in no longer than three months.

  • Removal of one lobe of the lung
    Removal of one lobe of the lung
  • Removal of two lobes of the lung
    Removal of two lobes of the lung

See also

References
  1. Biderman, Arthur; Venes, Donald; Taber, Clarence Wilbur (2009). Taber's cyclopedic medical dictionary. Philadelphia: F.A. Davis Co. p. 1359. ISBN 978-0-8036-1561-8.
  2. Deslauriers J, Grégoire J (April 2000). "Surgical therapy of early non-small cell lung cancer". Chest. 117 (4 Suppl 1): 104S–109S. doi:10.1378/chest.117.4_suppl_1.104s. PMID 10777463.
  3. "Lobectomy". www.hopkinsmedicine.org. 22 November 2019.
  4. "What is a Lobectomy and What Can You Expect?". About.com. Archived from the original on 2015-12-08. Retrieved 2015-12-05.
  5. Casha AR, Bertolaccini L, Camilleri L, Manche A, Gauci M, Melikyan G, Gatt R, Dudek K, Solli P, Grima JN (June 2018). "Pathophysiological mechanism of post-lobectomy air leaks". Journal of Thoracic Disease. 10 (6): 3689–3700. doi:10.21037/jtd.2018.05.116. PMC 6051860. PMID 30069367.
  6. Venuta F, Rendina EA, De Giacomo T, Flaishman I, Guarino E, Ciccone AM, Ricci C (April 1998). "Technique to reduce air leaks after pulmonary lobectomy". European Journal of Cardio-Thoracic Surgery. 13 (4): 361–4. doi:10.1016/s1010-7940(98)00038-4. PMID 9641332.
  7. Noah Lechtzin. "Thoracotomy". Merck Manuals. Archived from the original on April 22, 2015.
  8. Yu, Kyung-ah; Kim, So-rin; Ahn, Tae Hwan; Lee, Min Yeong; Kim, Hwi-yool (March 2023). "Evaluation of LigaTie device for total lung lobectomy in small breed dogs - An ex vivo study". Research in Veterinary Science. 156: 29–35. doi:10.1016/j.rvsc.2023.01.015. PMID 36773582. S2CID 256297905.
  9. Ziarnik, Elena; Grogan, Eric L. (2015). "Postlobectomy Early Complications". Thoracic Surgery Clinics. Elsevier BV. 25 (3): 355–364. doi:10.1016/j.thorsurg.2015.04.003. ISSN 1547-4127. PMC 4606870. PMID 26210931.
  10. Port JL, Mirza FM, Lee PC, Paul S, Stiles BM, Altorki NK (December 2011). "Lobectomy in octogenarians with non-small cell lung cancer: ramifications of increasing life expectancy and the benefits of minimally invasive surgery". The Annals of Thoracic Surgery. 92 (6): 1951–7. doi:10.1016/j.athoracsur.2011.06.082. PMID 21982148.
  11. "Lung Surgery for Lung Cancer". webmd.com.
  1. Ishigaki, Kumiko; Höglund, Odd Viking; Asano, Kazushi (9 March 2021). "Resorbable self‐locking device for canine lung lobectomy: A clinical and experimental study". Veterinary Surgery. 50: O32–O39. doi:10.1111/vsu.13623. PMID 33687090. S2CID 232161534.
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