What is Pneumonectomy?

Dr Priya Sharma

Dr Priya Sharma

BDS (Bachelor of Dental Surgery), 6 years of experience

February 28, 2022 Chest Diseases 466 Views

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What is the meaning of Pneumonectomy?

A surgical procedure done for the removal of an entire lung to treat certain lung diseases is known as pneumonectomy or lung removal. Pneumonectomy is generally performed in cases where a small portion of lung removal is unable to treat the lung disorder.

One can live a normal life with just one lung. However, one needs to modify their activities and follow an exercise regime to prevent shortness of breath. In this article, we will be discussing pneumonectomy in detail –

  • What are the types of Pneumonectomy?
  • What is the purpose of Pneumonectomy?
  • What are the symptoms that may indicate the need for a Pneumonectomy?
  • What is the diagnostic procedure before a Pneumonectomy?
  • How to prepare for a Pneumonectomy?
  • What is the procedure for a Pneumonectomy?
  • How to care after a Pneumonectomy?
  • What are the risks of Pneumonectomy?
  • What is the cost of Pneumonectomy in India?

What are the types of Pneumonectomy?

Pneumonectomy can be of the following different types:

  • Simple pneumonectomy: A surgical procedure in which the entire affected lung is removed is known as simple pneumonectomy. 
  • Extrapleural pneumonectomy: A surgical procedure that involves the removal of the diseased lung along with parts of the diaphragm (a muscle present below the lungs that helps in respiration), pericardium (the membrane lining the heart), and pleura (the lining surrounding the lungs). This procedure is usually performed in cases of mesothelioma (cancer that begins in the pleura).
  • Completion pneumonectomy: This type of surgical procedure is done to remove a lung whose some part was previously removed by a surgical procedure.

What is the purpose of Pneumonectomy?

A pneumonectomy is needed in the following cases:

  • Lung cancer
  • Malignant (cancerous) mesothelioma
  • Traumatic injury to the lung
  • Obstruction of the bronchus (a tube that connects the trachea or windpipe to the lungs)
  • Congenital lung disease (lung disease present at birth)
  • Lung infections like tuberculosis (a bacterial infection) and fungal infections ( Know more about- What is Lung Cancer? )
  • Bronchiectasis (damage to the lung airway)

What are the symptoms that may indicate the need for a Pneumonectomy?

The following disorders may be noticed due to a lung disorder, which may require a pneumonectomy procedure for treatment:

What is the diagnostic procedure before a Pneumonectomy?

  • Physical examination: The doctor will examine the patient physically and check the symptoms of the patient.
  • Blood tests: These tests are done to make sure that the patient’s overall health is good and the patient is physically fit for the surgery.
  • Imaging tests: Imaging tests like chest x-rays, CT scans, MRI scans, and PET scans may be recommended to obtain a clear picture of the lungs and check for the extent of lung disease.
  • Echocardiogram: Sound waves are used in this test to obtain clear images of the heart.
  • Electrocardiogram (ECG): This test helps in checking the rhythm of the heart.
  • Biopsy: A small portion of the lung tissue is removed by the doctor to check for the presence of cancer cells or other lung diseases under the microscope. ( Know more about- Lung Biopsy )
  • Spirometry: This test helps to check lung function.

How to prepare for a Pneumonectomy?

  • Inform the doctor about any medications, herbs, or supplements that you could be taking.
  • Inform your doctor if you are suffering from any medical illnesses.
  • If you are allergic or sensitive to any medicines, anesthetic agents, latex, tape, or iodine, inform the doctor before the surgery.
  • Smoking should be stopped at least a few days before the procedure.
  • The doctor may ask you to stop the consumption of blood-thinning medications like warfarin and aspirin a couple of days before the procedure.
  • You will be told to not eat or drink anything eight hours before the procedure.

What is the procedure for a Pneumonectomy?

The procedure is done under general anesthesia (the patient is put to sleep during the procedure).

Pneumonectomy can be done using any one of the following techniques:

Open surgery (thoracotomy):

  • This is the most preferred procedure done for the removal of a lung.
  • The surgeon makes a long incision between two ribs.
  • The incision goes from under the arm to around the back, on the side of the affected lung.
  • The surgeon then separates the two ribs.
  • In some cases, the surgeon may excise a small portion of the fifth rib for better access to the lungs. ( Know more about- What is Lung Transplant ? )
  • The affected lung is deflated by the surgeon.
  • The deflation of the lungs is done by clamping and dividing the pulmonary artery and vein (the main blood vessels entering and leaving the lung).
  • The surgeon also clamps and divides a part of the bronchus.
  • The diseased lung is removed from the chest region.
  • In the case of an extrapleural pneumonectomy, parts of the diaphragm, pericardium, and pleura are also excised.
  • A drainage tube is left behind in the pleural space (the cavity present between the lungs and underneath the chest wall). 
  • The drainage tube drains out the air, fluid, and blood from the chest area. It is generally removed after the patient’s condition improves.
  • The ribs, muscles, and skin are closed using stitches (sutures).
  • A dressing is applied by the doctor over the incision area.

Video-assisted thoracoscopic surgery (VATS):

  • It is a minimally-invasive procedure.
  • Small incisions are made in the chest region.
  • A thoracoscope (a thin, lighted instrument with a camera on one end) and some surgical instruments are inserted through these incisions.
  • The camera of the thoracoscope helps in obtaining the images of the chest during the surgery on a monitor screen. ( Know more about- What is Lung Cancer Screening? )
  • The affected lung is deflated and exercises.
  • The incisions are closed by sutures.
  • This procedure is less painful and has a quicker recovery compared to open surgery.

How to care after a Pneumonectomy?

  • The patient normally stays in the hospital for a week or two after the procedure.
  • The vital parameters of the patient are monitored during their stay in the hospital.
  • A temporary drainage tube that comes out through the chest may be given to drain the blood, air, and fluids.
  • It is normal to experience some pain and soreness after the procedure. The doctor will prescribe pain-relieving medicines for the same.
  • Avoid strenuous activities and heavy lifting for 6 to 8 weeks after the surgery.
  • The doctor may recommend physical therapy and breathing exercises to help in a rapid recovery.
  • The sutures will be removed by the doctor in a follow-up appointment.
  • It is normal to get fatigued easily after the surgery. It may take a few weeks before the patient regains his/her original strength.
  • Follow the doctor’s post-surgery instructions carefully.
  • Visit your doctor immediately if you notice symptoms like fever, infection, severe pain, or swelling.

What are the risks of Pneumonectomy?

The following complications may occur due to a pneumonectomy:

  • Infection 
  • Bleeding
  • Blood clot formation
  • Allergic reaction to anesthesia
  • Respiratory failure (failure of the respiratory system to provide adequate oxygen to the body and remove sufficient carbon dioxide from the body)
  • Arrhythmia (abnormal heart rhythm)
  • Decrease in blood flow to the heart
  • Shortness of breath
  • Fluid buildup in the space left behind after the removal of a lung
  • Tissue and organ movement into the space left behind after lung removal
  • Collapsed lung (deflated lung due to air entering the chest cavity)
  • Death

What is the cost of Pneumonectomy in India?

The total cost of pneumonectomy in India can range from around INR 2,25,000 to INR 3,75,000. However, many prominent hospital doctors in India specialize in pneumonectomy. But the cost varies across different hospitals. 

If you are coming from abroad, apart from the cost of pneumonectomy, there will be an additional cost of living in a hotel and the cost of local travel. After the procedure, the patient is kept for seven days in the hospital and fourteen days in the hotel for recovery. So, the total cost of pneumonectomy in India comes from a total of INR 3,00,000 to INR 5,00,000. 

We hope that we could answer all your questions regarding pneumonectomy through this article.

If you need more information about pneumonectomy, you can contact a Cardio-vascular and Thoracic Surgeon.

We only aim to provide you with information through this article. We do not recommend any medication or treatment to anyone. Only a qualified doctor can give you the best advice and correct treatment plan. 

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