Pneumonectomy

What are types of pneumonectomy?

There are two types of pneumonectomy:

• Traditional pneumonectomy — only the diseased lung is removed
• Extra pleural pneumonectomy — the diseased lung is removed along with portions of the diaphragm, pericardium (membrane over the heart) and pleura (chest cavity membrane lining).
• Video-assisted thoracic surgery (VATS) — VATS is a minimally invasive surgery to remove a lung. Recovery time is shorter after a VATS compared to a traditional pneumonectomy. Not all patients are candidates for a VATS.

Who is a candidate for a pneumonectomy?

A pneumonectomy is most commonly used to treat patients with lung cancer. It is most appropriate for patients who have a lung tumor in the middle of the lung or a tumor that involves a large portion of the pulmonary artery or veins.

Patients who have mesothelioma (cancer of the pleura) are also candidates for a pneumonectomy. Mesothelioma is typically caused by exposure to asbestos.

Patients who have been severely wounded in the chest may also be candidates for a pneumonectomy.

What are the risks associated with a pneumonectomy?

Risks associated with a pneumonectomy include:

• Cardiac arrhythmias
• Heart attack
• Needing a mechanical respirator
• Pneumonia
• Wound infection
• Blood clot in the lungs that could lead to a pulmonary embolism
• Fluid accumulating in the lungs
• Kidney failure

Longer-term, some patients experience shortness of breath and require oxygen.

What to expect during a pneumonectomy

A pneumonectomy is an invasive procedure performed under general anesthesia so that you are not awake during the surgery. Most patients have an endotracheal tube inserted to help them breathe throughout the surgery.

During the procedure, your surgeon will make an incision into the patient’s side (on the side of the affected lung). The incision will run from below the shoulder blade to the front of the chest. The surgeon will spread the ribs to access the diseased lung. Your surgeon will collapse the lung and then tie off any major blood vessels and bronchi to the lung. Once this is complete, the surgeon will remove the lung, insert drainage tubes to drain fluid, air and blood out of the cavity. Once any bleeding is controlled, your surgeon will close the incision site with sutures.

Recovery from a pneumonectomy

The recovery process after a pneumonectomy is a lengthy one. After the surgery, you will remain in the hospital for up to ten days. Your care team will closely monitor all your vital signs and the function of the remaining lung.

After you are discharged from the hospital, you can slowly resume your day-to-day activities. Over time, your remaining lung will compensate for the loss of the other lung. Many patients require six or more months to recover completely.