Lung Resection

About Lung Resection

Lung resection is the surgical removal of part or all of a lung, performed mainly for lung cancer, the leading cause of cancer death worldwide, and also for metastases from other cancers, infections, bronchiectasis and some benign lesions. Types include wedge resection, a non anatomical removal of a small peripheral portion; segmentectomy, removal of an anatomical segment; lobectomy, removal of an entire lobe; and pneumonectomy, removal of a whole lung. Lobectomy with sampling or removal of the mediastinal lymph nodes has long been the standard curative operation for early non small cell lung cancer, and recent randomized trials have shown that segmentectomy can be an alternative for selected small peripheral tumors. In an anatomical resection the pulmonary artery branches, pulmonary vein and bronchus supplying the lobe or segment are individually divided, usually with staplers. Video assisted thoracoscopic surgery and robotic surgery have replaced open thoracotomy for many early stage cancers, generally offering less pain and a shorter hospital stay. Fitness for surgery is assessed with lung function tests and sometimes exercise testing. Complications include prolonged air leak, atrial fibrillation, pneumonia, bleeding and, rarely, a bronchopleural fistula, a breakdown of the closed bronchus. Lung volume reduction surgery for severe emphysema removes the most damaged tissue to improve breathing mechanics, and the National Emphysema Treatment Trial helped identify which patients benefit most.