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Pneumonectomy

Because pleural mesothelioma patients are often diagnosed when their cancer has reached the advanced stages of development, most patients are not candidates for any sort of curative surgery. However, with the advent of better diagnostic tests for the disease, including the Mesomark® Assay, more patients may become better candidates for surgery. One surgery used for pleural mesothelioma patients is a pneumonectomy, which has the potential of curing the cancer or sending it into remission.

What is a Pneumonectomy?

A pneumonectomy is a surgery that involves the removal of the affected lung. When only one lobe is removed, the procedure is referred to as a lobectomy. When just a segment is removed, it is known as a segmentectomy or wedge resection. It has been an accepted procedure for the treatment of lung cancer since the early 1900s, but it originally required more than one surgery. In 1933, a single-step pneumonectomy was successfully performed for the first time.

The prime candidate for pneumonectomy is an individual who has early stage pleural mesothelioma and is in otherwise relatively good health. This is a serious and aggressive surgery that often requires a long recovery period and it is only recommended for a very small percentage of pleural mesothelioma patients. In some cases it has been attempted for palliative purposes but with little success.

What to Expect During a Pneumonectomy

A patient will undergo extensive testing before a doctor determines whether or not they are a candidate for surgery. The cancer’s stage of development will be evaluated and imaging tests such as CT scans or MRIs may be performed. The lung that is expected to remain after surgery will also be tested to determine whether it is strong enough to assume the job of two lungs.

The surgery is performed in a hospital operating room under general anesthesia. During the procedure, the surgeon collapses the affected lung and ties off the blood vessels. Cuts are made in the proper places and the lung is carefully removed. Closure of the bronchial tube is completed with sutures or staples and a temporary drain remains in the pleural space that surrounded the lung that was removed.

After a pneumonectomy, patients are generally taken to the Intensive Care Unit (ICU) due to the seriousness of this procedure. A respirator will remain in place for at least 24 hours and a chest drainage tube will be left intact as well. When the patient is breathing on their own and no complications are apparent, he or she will be moved out of the ICU.

The length of hospital stay for a pneumonectomy is generally about seven to 14 days. Recovery at home can be very slow and painful so the patient should have a caregiver who can donate the time needed to properly supervise recovery. Both the patient and caregiver should be aware of potential complications, which may include infection, heart problems, pneumonia, pulmonary embolism (blood clots in the remaining lung), pus or fluid accumulation, kidney failure, and bronchopleural fistula (an abnormal fusion of the stump of the cut bronchus and the pleural space).

Sources:

1. http://www.intelihealth.com/IH/ihtIH/E/9339/23692.html
2. http://lung-cancer.emedtv.com/pneumonectomy/pneumonectomy.htm