Thoracic surgery remains the preferred treatment for lung cancer with curative intent. Recent clinical advancements in pulmonary care and surgical techniques are improving patient outcomes.
Before surgery, you’ll need imaging and tests to determine how well your lungs work (pulmonary function). These may include a CT scan. Other tests may also be done to look for cancer in other body parts.
If a tumor is so large that it can’t be removed with a more minor surgery, a thoracic surgeon like Armen Parajian may recommend pneumonectomy. This involves removing an entire lung. The surgeon may also remove the diaphragm, a portion of the sac surrounding the heart (pericardium), and the membrane that lines the inside of the chest cavity (pleura).
You must prepare for this procedure by making arrangements for someone to care for your pets and home while you are in the hospital for up to 10 days. You may need to wear a mask for breathing or have tubes in your chest that remove air and fluid.
During the operation, you will be given general anesthesia and put to sleep. The surgeon will make an incision and may spread or remove a rib to gain access to your lung. The surgeon will then remove the tumor. Your lung function will be reduced after the operation but slowly return to normal over time.
A lung cancer that is in just one part of the lung can be removed with a lobectomy. It is usually the primary treatment for early-stage lung cancer.
For this procedure, your surgeon makes an extended cut in the side of your chest (thoracotomy). Then, they separated two ribs to get to the affected lobe. They will remove the lobe and some nearby lymph nodes, which help show how advanced the cancer might be.
Improvements in surgical techniques and enhanced recovery have made lobectomy possible for older patients and those with more medical problems. However, the surgery can still be complicated for some people, and they may find that demanding activities make it harder to breathe than before. If that happens, a doctor may recommend periodic checkups to see how your lungs work. They may also order other tests, such as X-rays. You may also need oxygen therapy to support your breathing while you recover.
A wedge resection is less extensive than a lobectomy or pneumonectomy, but it’s still major surgery. Your healthcare providers will help you recover from the procedure and optimize your lung function as you heal.
This surgery is usually done to remove tiny lung cancer tumors, including early-stage NSCLC or squamous cell carcinoma (SCC). It may also remove isolated metastases from other body parts that have spread to the lungs.
A wedge resection takes out a triangle-shaped piece of lung tissue and some surrounding tissue. It’s performed via video-assisted thoracoscopic (VATS) surgery.
While recent American series comparing wedge resection with lobectomy have unsurprisingly included patients with poor cardiopulmonary reserve, some new data suggest sub-lobar resection may offer an oncologic equivalent to lobectomy in medically fit older adults with clinical stage IA lung cancer. It’s essential that surgeons who perform this type of surgery routinely perform hilar and mediastinal lymph node sampling and ensure a wide margin is maintained.
Thoracoscopy is a small operation to check for cancer in the space between your lungs and ribcage (thoracic cavity). Your doctor will make 1 to 3 minor cuts (incisions) on your side of the chest. They will then attach a flexible tube with a light and video camera called a thoracoscope.
This allows your doctor to see inside your thoracic cavity, including the tissues that line your lung (pleura). They can take samples of these tissues (biopsies) for testing. They can also drain any fluid from this area, called pleural effusions.
Your doctor can use the thoracoscope to remove malignant cells from your lungs. They can also use it to remove fluid from the pleural cavity and give you medicine to prevent the recurrence of the fluid build-up (chemical pleurodesis). Your doctor may perform this procedure while you are awake but sedated. After the operation, you may feel sore in the chest wall, but painkillers can help.