Lung Cancer Surgery

Lung cancer surgery is an option for some patients depending on the type, location and stage of their lung cancer and other medical conditions. Attempts to cure lung cancer with the surgery involve removing the tumor along with some surrounding lung tissue and often lymph nodes in the region of the tumor. Removing the tumor with lung cancer surgery is considered the best option when the cancer is localized and unlikely to have spread. This includes early stage non-small cell lung cancers and carcinoid tumors.

Surgery may be the only step in lung cancer treatment, the first step or it may follow other treatments. The following surgical procedures are used to treat lung cancer:

How Is Lung Cancer Surgery Performed?

There are two commonly used approaches to removing portions of the lung. The choice depends on the location, size and stage of the lung tumor and the expertise of the surgeon.

• Thoracotomy
  This is an incision on the side of the chest and follows the curve of your ribs. It typically involves dividing some of the muscles of the chest wall and uses an instrument to gently spread between two ribs to provide the surgeon access to the lung. The muscles are repaired when the incision is closed.
• Minimally invasive surgery
  This approach typically involves 1 to 4 small incisions to access the inside of the chest. The surgeon uses a camera to visualize the lung and special instruments to perform the surgery. This is known as thoracoscopy or video-assisted thoracoscopic surgery (VATS) and can also be done with the assistance of a surgical robot.

Types of Procedures

• Lobectomy
  • The right lung is divided into three lobes; the left lung has two lobes.
  • Lobectomy is the removal (resection) of the lobe of the lung affected by lung cancer. This is the most commonly performed lung cancer surgery.
  • A bilobectomy is the removal of two lobes and is only done for tumors of the right lung where the tumor involves two adjacent lobes. This can result in a right upper and middle bilobectomy or a right middle and lower bilobectomy.
  • A lung cancer surgery called a sleeve lobectomy is also sometimes done. These tumors typically involve one lobe as well as the main bronchus to that lung. A sleeve resection starts with the removal of the cancerous lobe and a portion of the main bronchus to that lung. The remaining end of the main bronchus is then rejoined with the bronchus to any unaffected lobe(s). When done a sleeve lobectomy avoids the need for a pneumonectomy (see below).
• Segmentectomy
  • Each lung lobe is made up of two to five lung segments.  Surgeons can remove one to four segments of certain lobes and save uninvolved tissue.
• Wedge Resection
  • A wedge resection is the removal of a small, wedge-shaped part of the lung tissue surrounding the cancerous tumor.
• Pneumonectomy
  • Pneumonectomy is the removal of the entire lung affected by cancer. This lung cancer procedure is usually done if the cancer cannot be fully removed with the lobectomy or if the lesion is centrally located.

Possible Lung Cancer Surgery Side Effects

Each type of lung cancer treatment option has possible side effects.It is important to know the potential side effects and ways to cope with them before beginning lung cancer treatment. You might experience:

• Pain
• Possible complications from the lung cancer surgery

Discuss concerns, possible side effects and any effects that you experience with your surgeon. Download a list of suggested questions.