LUNG RESECTION

General Information

DEFINITION--Removal of tissue from the lungs. If part of a lung (usually called a lobe) is removed, the surgery is called lobectomy. If the entire lung is removed, the surgery is called pneumonectomy.

BODY PARTS INVOLVED--Lung; bronchial tubes; blood vessels in chest; ribs.

REASONS FOR SURGERY

• Cancer or suspected cancer of the lung.
• Diseased lobes of the lung caused by several chronic conditions, especially bronchiectasis.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Alcoholism or chronic illness.
• Recent illness, especially upper-respiratory infection.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs, including: narcotics; psychedelics; hallucinogens; marijuana; or cocaine.

What To Expect

WHO OPERATES--Thoracic surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of chest; ECG (See Glossary).
• During surgery: ECG monitor.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the chest. Sometimes, a rib is removed for better exposure to the lungs.
• The blood supply to the diseased area is isolated and tied off.
• The diseased area is located and examined. The growth, the lobe in which it appears or the entire lung is cut free and removed along with lymph nodes in the area.
• A tube is inserted to drain fluid and air from the surgical area.
• The muscles are reconstructed with strong sutures. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS--Excessive bleeding; surgical-wound infection; pneumonia; respiratory crippling; bronchial fistula.

AVERAGE HOSPITAL STAY--10 to 14 days.

PROBABLE OUTCOME--In some cases, underlying lung disease may be cured. In other cases, quality of life may be improved. Allow about 6 weeks for recovery from surgery.

Postoperative Care

† Move and elevate legs often while in bed to decrease the likelihood of deep--

vein blood clots.

• Breathe deeply and cough often to keep secretions from pooling inside the lungs. Respiratory therapists can help you learn to keep bronchial tubes clear. Ask your doctor.

† You may use non--prescription drugs, such as acetaminophen, for minor pain.

ACTIVITY

• Resuming daily activities, including work, as soon as you are able can help the healing process.
• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when able.
• Resume driving 5 weeks after returning home.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting or shortness of breath.
• You develop a "bubbly" feeling under skin of your chest.