A pneumonectomy is a surgery performed to remove an entire lung. Thoracic surgeons and our Surgical Oncology team perform the procedure to treat non-small cell lung cancer. It may also be performed to treat conditions such as chronic obstructive pulmonary disease (COPD) and tuberculosis.
The types of pneumonectomy procedures include:
Standard pneumonectomy: Only the diseased left or right lung is removed.
Extrapleural pneumonectomy: The diseased left or right lung is removed, in addition to portions of the diaphragm, pericardium (the membrane covering the heart) and the pleura (the membrane lining the chest cavity). An extrapleural pneumonectomy is typically performed to treat mesothelioma.
To perform a pneumonectomy, a surgeon makes a long incision into the patient’s side (on the same side where the diseased lung is located). The incision follows the curve of the ribs, from below the shoulder blade to the front of the chest. The surgeon then spreads the ribs, and in some cases, removes a portion of a rib to access the diseased lung. The lung is then collapsed and major blood vessels leading to the lung are tied off. The bronchus leading to the lung is tied off and stapled or sewn shut. The lung is removed. Temporary drainage tubes are inserted into the pleura to draw blood, fluid and air out of the surgical cavity. The surgeon then checks to see that bleeding is controlled before he or she closes the incisions.
Pneumonectomy procedures are invasive and complex. Patients receive general anesthesia so that they sleep through the procedure. Patients also have an endotracheal tube placed in their mouths, which allows a ventilator to breathe for them during the surgery.
A pneumonectomy may be recommended as a treatment option, depending on several factors, including:
- The location and size of the tumor
- Whether the disease has spread to other areas
- How well the lungs are functioning prior to the surgery
- The patient’s overall health
Patients who undergo a pneumonectomy are hospitalized for about 10 days. Recovery can take some time. Gradually, the remaining lung takes over for the lung that has been removed.