What is pneumonectomy?
A pneumonectomy is a type of surgery to remove one of the lungs.
Lungs are a part of the respiratory system that removes oxygen from the air and pass it into your blood. Every individual has two lungs; these lungs connect to mouth through a series of tubular structures. A pneumonectomy is a type of surgery to remove one of the lungs. It is done as a treatment for cancer, injury, or infection. One lung can provide enough oxygen and remove enough carbon dioxide from the body.
Extrapleural pneumonectomy is a surgery to resect (remove) the affected lung along with its pleura (covering), lymph nodes (draining channels) of the affected side along with half the diaphragm.
When is pneumonectomy required?
Lung cancer is the most common reason for a pneumonectomy. Sometimes a pneumonectomy is also needed for other lung diseases, some of these include:
- Severe lung injury
- Lung tuberculosis
- Infections of the lung
- Bronchiectasis (a disease in which there is a permanent enlargement to the bronchial tubes)
- Birth-related lung abnormalities
- Airway blockage
- Pulmonary metastases (cancer that has spread to the lungs from another site in the body)
Who performs pneumonectomy?
Pneumonectomy is usually performed by a team of surgeons or doctors who specialize in lung operations (pulmonary surgeons/pulmonologists). During the procedure patient will lie on the side on an operating table with the arm above the head, they may probably get antibiotics to help prevent infection.
- The patient will be given general or epidural anesthesia before the surgery.
- The surgeon makes a cut several inches long between two ribs. The cut will go from under the arm to around the back, on the side of the lung that is being removed.
- The surgeon separates two ribs. In some cases, the surgeon might remove a small part of the rib.
- The surgeon deflates the affected lung and removes it.
- The surgeon may remove some nearby lymph nodes. These may help show how advanced cancer might be.
- The surgeon will close the ribs, muscles, and skin. A dressing will be applied over the incision.
- Most of the time, a chest tube will remain in the pleural space from where the lung was removed. This can later be removed when the condition improves.
What are the risks of pneumonectomy?
Many people who have a pneumonectomy do very well. But it is fairly high-risk surgery. Some possible complications are:
- Respiratory failure
- A blood clot in the lung (pulmonary embolism)
- Infection in the lungs (pneumonia, emphysema)
- Shock
- Complications from anesthesia (headache, drowsiness, and nausea)
- Bleeding
- Abnormal heart rhythms
- Reduced blood flow to the heart
- Pain at the site of operation
- Cardiac tamponade (collection of large amounts of fluid around the heart, hampering its beating)
- If the patient has emphysema or chronic bronchitis (common diseases among smokers), they might experience shortness of breath during certain activities.
- Herniation of the heart
- Bronchopleural fistula (an abnormal connection between lung and its covering)
What is the recovery time after pneumonectomy?
Patients may get easily tired after the surgery. But will slowly start to recover strength. It may take several weeks to a month before they recover completely. If the surgeon separates the ribs to get to the lung, the area near the incision will hurt for some time after surgery. Overall physical activities may be limited for one to two months.