Lung cancer surgery
Lung cancer surgery describes the use of surgical operations in the treatment of lung cancer. It involves the surgical excision of cancer tissue from the lung. It is used mainly in non-small cell lung cancer with the intention of curing the patient.
Not all patients are suitable for operation. The stage, location and cell type are important limiting factors. In addition, patients who are very ill with a poor performance status or who have inadequate pulmonary reserve would be unlikely to survive. Even with careful selection, the overall operative death rate is about 4.4%.
In non-small cell lung cancer, stages IA, IB, IIA, and IIB are suitable for surgical resection.
Pulmonary reserve is measured by spirometry. If there is no evidence of undue shortness of breath or diffuse parenchymal lung disease, and the FEV1 exceeds 2 litres or 80% of predicted, the patient is fit for pneumonectomy. If the FEV1 exceeds 1.5 litres, the patient is fit for lobectomy.
Types of surgery
- Lobectomy (removal of a lobe of the lung) See a video of a Lobectomy
- Sublobar resection (removal of part of lobe of the lung)
- Segmentectomy (removal of an anatomic division of a particular lobe of the lung)
- Pneumonectomy (removal of an entire lung)
- Wedge resection
- Sleeve/bronchoplastic resection (removal of an associated tubular section of the associated main bronchial passage during lobectomy with subsequent reconstruction of the bronchial passage)
- VATS lobectomy (minimally invasive approach to lobectomy that may allow for diminished pain, quicker return to full activity, and diminished hospital costs)
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