Lung lobe resection – lobectomy
Lung lobe resection or lobectomy, in most cases, is performed in the case of lung cancer, when it is necessary to remove the tumor. In other cases, indications for lung lobe lobectomy may be conditions such as pulmonary edema, chest damage, or severe infections.
We collaborate with leading Israeli cardiothoracic surgeons who perform lung lobe removal operations at one of the leading Israeli hospitals.
Lung cancer is one of the most common types of cancer in the world. Primary lung cancer is cancer that originates from lung tissue, while secondary lung cancer starts in another part of the body and spreads to the lungs (metastases).
Approximately 30% of patients are diagnosed in the early stages of the disease, which can be treated with lobectomy (usually in the 1st and 2nd stages, but the lung lobe resection operation can also be performed in the 3rd stage).
In the later stages of the disease, when metastases have spread to other organs, lung lobe resection surgery is not considered the initial method, but radiation therapy or chemotherapy is usually prescribed.
More than 80% of lung cancer is non-small cell lung cancer. With this type of cancer, a lobectomy to remove a lung tumor can be performed, while for small cell lung cancer lung lobe resection surgery is not indicated, except in some cases. The method and extent of the lobectomy depends on the type, size and location of the tumor.
There are three methods of surgery to remove a lobe of the lung:
• Lung wedge resection – an operation during which a small segment of the lung is excised. Such an operation is performed when the lung function is impaired.
• Lobectomy – removal of the lobe of the lung.
• Pneumonectomy – removal of the lung.
How is the lung lobe resection done
Our leading cardiothoracic surgeons perform lung lobe resection using a mini-invasive method, through 3 small punctures in the chest without separation or damage to the ribs. This method is called VATS thoracoscopy or lobectomy. The operation is performed under general anesthesia, before which the patient will be given a sedative to reduce anxiety.
During the operation, a bronchoscope and a two-channel breathing tube are inserted into the patient’s lungs and into the patient’s trachea, since during the operation the respiratory function is performed only by the non-operated lung. The bronchoscope is an optical tube with a camera that allows the surgeon to monitor the operated area on the operating room screens.
Depending on the case, some patients have an epidural catheter to relieve postoperative pain. This catheter also remains in the postoperative days to provide self-control of the introduction of anesthesia in accordance with the level and pain threshold of the patient.
Our experts are doing everything possible so that the lobectomy can be performed in a minimally invasive way, rather than open.
Along with the affected lobe, the surgeon also assesses the condition of the regional sentinel lymph nodes to check the spread of metastases. Sometimes a frozen sectional biopsy is also performed during surgery, a quick test that can give the surgeon an indication of complete tumor removal, and sometimes to diagnose the type of tumor. At the end of the lung lobe resection the surgeon removes surgical instrument and camera from the patient’s body, sutures surgical punctures. The lobectomy takes about 2-3 hours.
Success rates and risks of lung lobe resection surgery
Mini-invasive thoracoscopy causes much less pain compared to open surgery. Recovery time is much shorter compared to open surgery. Postoperative survival in lung cancer is 25-75%, depending on the stage of spread of the disease.
Despite the minimally invasive approach, lung lobe resection surgery is a complex but successful procedure. The average mortality rate from surgery is less than 1%. The complication rate is about 3%. The most common complication is airflow from the stump area for several days. Other complications include bleeding, infection, shortness of breath, pulmonary thromboembolism, and pneumonia. Rarer complications include cardiac arrhythmia, heart attack, stroke, empyema, and renal failure. Our surgeon informs patients about all the risks and complications during the consultation.
Preparation for lung lobe resection surgery and hospitalization in Israel
Before a lobectomy, a series of tests must be performed, such as chest x-ray, chest CT, CT guided lung biopsy, MRI, and sometimes bone scintigraphy. Bronchoscopy is usually used to take sputum samples. Mock samples are sent to the lab for cytologic analysis.