Pneumonectomy is a surgical procedure done for the removal of one of the lungs to treat severe lung diseases.
Pneumonectomy is most commonly performed to treat lung cancer. An individual can survive with just one lung, but the person will have to modify their activity level and may have shortness of breath frequently following a pneumonectomy.
Types: The different types of pneumonectomy include:
Purpose: A pneumonectomy is performed to treat the following conditions:
Symptoms: The various symptoms that may indicate the need for a pneumonectomy include:
The following tests may be performed before a pneumonectomy:
The procedure is normally done under general anesthesia (the patient is put to sleep during the procedure).
The procedure can be performed using any one of the following methods:
1. Video-assisted thoracoscopic surgery (VATS):
This is a minimally-invasive type of surgery.
The surgeon makes small cuts or incisions in the chest region.
The surgeon inserts special instruments and a thoracoscope, which is a thin, lighted instrument with a camera on one end, through these incisions.
The surgeon views the inside of the body on the monitor that is attached to the camera of the thoracoscope.
The surgeon can see the inside of the chest on the video screen while doing the surgery.
The diseased lung is then deflated and removed from the chest region.
The incisions are closed using sutures (stitches).
This procedure is less painful than open surgery, and also has a quicker recovery as compared to open surgery.
2. Open surgery (thoracotomy):
This is the most commonly performed procedure for pneumonectomy.
The surgeon makes a long incision between two ribs, on the side of the diseased lung.
The incision goes down from under the arm to around the back.
The two ribs are separated.
In some cases, a small part of the rib is removed for better access.
The diseased lung is deflated.
The pulmonary artery and vein (the main blood vessels that enter and leave the lung) are clamped and divided.
A part of the bronchus (a tube connecting the trachea or windpipe and the lung) may also be clamped and divided.
The surgeon then removes the diseased lung from the chest region.
The surgeon may also remove some nearby lymph nodes.
A temporary drainage tube is usually left in the pleural space (the cavity between the lungs and the area under the chest wall) from the area of lung removal to allow the drainage of fluid, air, and blood. This chest tube is removed once the condition of the patient improves.
The ribs, muscles, and skin are closed using sutures.
A dressing is applied over the incision.
The complications associated with a pneumonectomy are:
Bleeding
Blood clot formation in the lung (pulmonary embolism)
Infection
Allergic reaction to anesthesia
Abnormal heart rhythm
Fluid buildup in the space left behind after removal of the lung
Collapsed lung (deflation of the lung causing difficulty in breathing, low oxygen in the blood, and chest pain)
Air leakage into the chest between the chest wall and lung
Movement of tissues and organs into the space left behind after the removal of a lung
Respiratory failure (the inability of the respiratory system to give sufficient oxygen to the body and adequate removal of carbon dioxide from the body)
Death
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Pneumonectomy is a surgical procedure done for the removal of one of the lungs to treat severe lung diseases.
Pneumonectomy is most commonly performed to treat lung cancer. An individual can survive with just one lung, but the person will have to modify their activity level and may have shortness of breath frequently following a pneumonectomy.
Types: The different types of pneumonectomy include:
Purpose: A pneumonectomy is performed to treat the following conditions:
Symptoms: The various symptoms that may indicate the need for a pneumonectomy include:
The following tests may be performed before a pneumonectomy:
The procedure is normally done under general anesthesia (the patient is put to sleep during the procedure).
The procedure can be performed using any one of the following methods:
1. Video-assisted thoracoscopic surgery (VATS):
This is a minimally-invasive type of surgery.
The surgeon makes small cuts or incisions in the chest region.
The surgeon inserts special instruments and a thoracoscope, which is a thin, lighted instrument with a camera on one end, through these incisions.
The surgeon views the inside of the body on the monitor that is attached to the camera of the thoracoscope.
The surgeon can see the inside of the chest on the video screen while doing the surgery.
The diseased lung is then deflated and removed from the chest region.
The incisions are closed using sutures (stitches).
This procedure is less painful than open surgery, and also has a quicker recovery as compared to open surgery.
2. Open surgery (thoracotomy):
This is the most commonly performed procedure for pneumonectomy.
The surgeon makes a long incision between two ribs, on the side of the diseased lung.
The incision goes down from under the arm to around the back.
The two ribs are separated.
In some cases, a small part of the rib is removed for better access.
The diseased lung is deflated.
The pulmonary artery and vein (the main blood vessels that enter and leave the lung) are clamped and divided.
A part of the bronchus (a tube connecting the trachea or windpipe and the lung) may also be clamped and divided.
The surgeon then removes the diseased lung from the chest region.
The surgeon may also remove some nearby lymph nodes.
A temporary drainage tube is usually left in the pleural space (the cavity between the lungs and the area under the chest wall) from the area of lung removal to allow the drainage of fluid, air, and blood. This chest tube is removed once the condition of the patient improves.
The ribs, muscles, and skin are closed using sutures.
A dressing is applied over the incision.
The complications associated with a pneumonectomy are:
Bleeding
Blood clot formation in the lung (pulmonary embolism)
Infection
Allergic reaction to anesthesia
Abnormal heart rhythm
Fluid buildup in the space left behind after removal of the lung
Collapsed lung (deflation of the lung causing difficulty in breathing, low oxygen in the blood, and chest pain)
Air leakage into the chest between the chest wall and lung
Movement of tissues and organs into the space left behind after the removal of a lung
Respiratory failure (the inability of the respiratory system to give sufficient oxygen to the body and adequate removal of carbon dioxide from the body)
Death
Pneumonectomy is a type of surgical procedure done for the removal of one of the lungs because of cancer, trauma, or other lung conditions.
Pneumonectomy may be required in the following cases:
The different symptoms that may indicate the need for pneumonectomy are:
A Thoracic Surgeon (also known as Cardiothoracic Surgeon) or a Pulmonologist can perform pneumonectomy.
The following diagnostic tests may be done before a pneumonectomy:
The following preparation may be required for a pneumonectomy:
The procedure is usually performed under general anesthesia (the patient is asleep during the procedure).
Pneumonectomy can be done using any one of the following techniques:
1. Open surgery (thoracotomy):
This is the most common type of procedure done for lung removal.
A long incision is made between two ribs.
The incision goes down from under the arm to around the back, on the side of the diseased lung.
The surgeon separates the two ribs.
In some cases, a small portion of the fifth rib is removed for better access to the lungs.
The diseased lung is then deflated by the surgeon.
The deflation of the lungs is done by clamping and dividing the pulmonary artery and pulmonary vein (the main blood vessels entering and leaving the lung).
The surgeon may also clamp and divide a part of the bronchus.
The diseased lung is excised from the chest region.
The surgeon may also remove adjacent lymph nodes, to check if cancer has spread to the nearby areas.
In case of an extrapleural pneumonectomy, the diaphragm, pleura, and pericardium are also removed by the surgeon.
A drainage tube is left by the surgeon in the pleural space (the cavity between the lungs and the area under the wall of the chest). It helps in draining out the air, fluid, and blood. This chest tube is temporary and is removed after there is an improvement in the condition of the patient.
The ribs, muscles, and skin are closed using stitches (sutures) or staples.
A dressing is applied over the incision area.
Video-assisted thoracoscopic surgery (VATS):
It is a minimally-invasive type of pneumonectomy surgery.
The surgeon makes small incisions in the chest region.
Some surgical instruments and a thoracoscope (a thin, lighted instrument with a camera on one end) are inserted through these incisions.
The surgeon can see the inside of the chest on the video screen, which is attached to the camera of the thoracoscope while doing the surgery.
The diseased lung is deflated and removed.
The incisions are closed using sutures.
This procedure is less painful and has a rapid recovery than open surgery.
The post-procedure steps after pneumonectomy are:
The following complications may be associated with a pneumonectomy procedure:
Normally, an individual having only one lung can live a normal and healthy life.
Most people can breathe without any exertion. However, some people may have shortness of breath and may require supplemental oxygen during some activities, and restriction in some daily activities.
The survival rate depends on factors like the stage and type of lung cancer, which lung needs to be removed (the prognosis for left pneumonectomy is better than right pneumonectomy), the sex of the patient (women have a better prognosis than men), and the overall health of the patient.
The five-year survival rate after pneumonectomy is about 21% to 38%.
The cost of pneumonectomy surgery varies depending on the age of the patient, the procedure being performed, and the overall health of the patient.
The cost varies amongst different doctors and in different hospitals. Normally, the cost of pneumonectomy in India ranges from INR 2,25,000 to INR 3,75,000.