Lung surgery
Once diagnosed with lung cancer and it’s determined that the tumour is resectable, you’ll undergo lung function tests and it will be determined if you’re fit for surgery. No eating six-hours prior to surgery and general anaesthesia will be administered.
Thoracotomy
There are two common approaches for lung cancer surgery which are thoracotomy and video-assisted thoracoscopic surgery (VATS). Thoracotomy is an incision made on the side of the chest, in-between the ribs to reach the lung and other organs in the chest. VATS is a minimally-invasive approach that involves generally one to four small incisions to access the inside of the chest with aid of long instruments and a camera. The aim is to remove part or the entire lung that is affected. The types of lung cancer procedures depend on size and location of the cancer.
Types of procedures
Wedge resection – Removal of a small wedge-shaped part of lung tissue surrounded by the tumour.
Segmentectomy – The lung is divided in different segments. This means removing the segment of the involved lung.
Lobectomy – Removal of the lobe of the lung affected by cancer.
Pneumonectomy – Removal of the entire lung affected by cancer.
Post-surgery
You’ll be woken up, extubated (removal of endotracheal tube from throat and windpipe) after surgery and admitted to ICU for monitoring and pain control. There will typically be one to two chest drains coming from the side of the chest placed anterior and the bottom of the chest, to monitor drainage and air leaks; these are generally removed after several days. A physiotherapist will come help with deep-breathing exercises, incentive spirometry and inspiratory muscle training aiming to improve lung expansion post-surgery.
Average spent in ICU is two to three days then transferred to the ward. You’ll be discharged once all chest tubes are out and you’re mobilising well.
Follow-up
Post-surgery follow-up is generally 10 to 14 days for general check-up and removal of sutures. Follow-up and surveillance are necessary with your oncologist.
If you are a smoker, you are advised to stop smoking. Ask your provider for help or call the National Council Against Smoking (NCAS) QUIT line:+27 011 720 3145 or WhatsApp: +27 72 766 4812.
Dr Lebo Mokotjo is a cardiothoracic surgeon in private practice, working at Netcare Milpark Hospital. She specialises in heart and lung transplantion.
Header image by Freepik