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Lobectomy- Lung
Depending on the lobe of the lung that is being removed, the different types of lung lobectomies are:
- Left upper lobectomy: It is the removal of the left lung’s upper lobe.
- Left lower lobectomy: It is the removal of the left lung’s lower lobe.
Purpose: A lobectomy is performed in the following cases:
- Bronchiectasis: A condition in which there is scarring and widening of the lung airways.
- Lung cancer: A type of cancer that begins in the lung.
- Benign tumor: It is a non-cancerous type of lung growth.
- Congenital cystic adenomatoid malformation: It is a non-cancerous mass of abnormal lung tissue present at birth.
- Lung blebs: These are large blisters in the lung that can lead to their collapse.
- Fungal infections: The fungal type of lung infections that are resistant to less invasive forms of treatment can be treated by lobectomy.
- Pulmonary sequestration: It is an abnormal type of lung tissue that does not function normally and usually develops before birth.
- Tuberculosis (TB): It is a chronic bacterial infection affecting the lungs.
- Lung abscess: It is an area of pus that may be formed in the lung.
- Emphysema: It is a type of chronic illness that occurs due to the breakdown of the elastic fibers in the lungs and makes it harder for the lungs to move on breathing.
The following diagnostic tests may be performed before a lobectomy procedure:
- Blood tests and urine tests: These are routine tests performed to check for underlying medical conditions.
- Chest x-ray: It helps the doctor to check the condition of the organs in the chest region.
- Electrocardiogram (ECG): This test helps the doctor to check the electrical activity of the heart.
- Imaging tests: Tests like x-rays and CT scans help the doctor to obtain images of the lungs and check for the presence of cancer.
- Ventilation/perfusion scan: This is a type of imaging test done to check how much of the lung can be safely removed.
- Bronchoscopy: It is a procedure in which a tube having a camera at its lower end is inserted through the mouth and throat and into the bronchi and lungs to check for the presence of any pathology.
- Pulmonary function tests: These tests are performed to check the functional capacity of the lungs.
The surgery is usually performed under general anesthesia (the patient is put to sleep during the procedure) and can be performed in the following different ways:
1. Open surgery or thoracotomy:
A long incision is made at the side of the chest.
The ribs are spread apart to easily visualize the diseased lobe and remove it.
2. Video-assisted thoracic surgery (VATS):
Two or four small incisions are made on the side of the chest.
A tube with a tiny video camera is used to look inside and guide other surgical tools.
This procedure is less painful and has a quicker recovery than open surgery.
3. Robot surgery:
The surgery is performed by robotic arms that are being controlled by the surgeon by looking at the monitor.
The procedure is performed by making three to four small incisions between the ribs.
The procedure has lesser bleeding, faster recovery, and lesser chance of infection compared to the other two techniques used.
The complications associated with a lobectomy procedure are:
- Infection
- Bleeding
- Allergic reaction to the anesthetic agent used
- Pneumothorax (lung collapse due to the air in the space between the lung covering, known as the pleural space)
- Empyema (pus area in the chest cavity)
- Pleural effusion (fluid in the space between the lung and inner chest wall)
- Bronchopleural fistula (a tube-like opening between the bronchus or airway and pleural space leading to the leakage of fluid or air into the chest area)
- Heart problems, like abnormal heart rhythm or a bleed around the heart
- You will stay in the recovery room for some time after the surgery, where your vital signs will be monitored.
- A chest x-ray may be performed immediately after the surgery to check if the lungs are fine.
- You will be given painkillers to provide relief from pain and discomfort after the procedure.
- You will be staying in the hospital for many days after the surgery.
- You will have one or more chest tubes near the incision area to drain the fluid and air from the chest region. These tubes are removed before you are discharged from the hospital.
- You will be taught coughing techniques and deep breathing exercises to help the lungs in re-expanding after surgery. This aids in breathing and prevents pneumonia.
- Oxygen supply may be needed for some time after surgery.
- You need to keep the incision clean and dry.
- Your doctor will give you bathing instructions.
- It is normal to feel some soreness in the surgical areas for a few days after the surgery.
- It is normal for your shoulder muscles and chest to pain after surgery, especially during coughing, physical activity, or deep breathing.
- The sutures or staples will be removed by the doctor in a follow-up appointment.
- Avoid heavy lifting and strenuous activities for a few months after the surgery.
- Avoid exposure to chemical fumes and environmental pollution.
- Quit smoking.
- Avoid contracting upper respiratory tract infections like cold and flu.
Lobectomy- Lung from one of the best multi-speciality hospital: Manipal Hospital Goa, Dona Paula, Panaji
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