What operation is performed for lung cancer?
First a diagnosis of lung cancer is established. This may be done by bronchoscopy, a transthoracic needle biopsy or by a video assisted minimally invasive operation. At this point, we will assume that the cancer is localized enough to have surgery play a role. If the lung cancer is early stage, surgery is usually the primary treatment. If the disease is more advanced, patients may be treated with chemotherapy or chemotherapy and radiation therapy before surgery.
For early staged tumors, a minimally invasive approach may be an option. For this, the surgery is done through smaller incisions without spreading the ribs to get into the chest. For more advanced disease or larger tumors, it may be necessary to perform the procedure through an open technique. Most often, surgeons perform either a posterolateral thoracotomy or a muscle-sparing incision to remove a lung cancer. Sometimes the muscles on the back may be divided as part of the procedure or a muscle-sparing incision may be used, If you are about to undergo surgery for lung cancer it is important to ask your surgeon about these approaches and what is best for you.
As part of the planned procedure, you may have an epidural. After you are asleep, the surgeon usually performs a bronchoscopy. Then you may have a mediastinoscopy to sample the lymph nodes surrounding the trachea. If the lymph nodes have tumor cells in them and they are on the opposite side as the primary tumor, surgery usually does not play a primary role in the management of this stage. If the tumor has spread to the lymph nodes on the same side as the primary tumor, ipsilateral, you may receive neo-adjuvant therapy before having your lung cancer removed. To more clearly understand the issue of lung cancer staging, please visit this website: www.cancer.gov/cancerinfo/wyntk/lung.
Most often, surgeons perform either a posterolateral thoracotomy or a muscle-sparing incision to remove a lung cancer. However, other approaches may be recommended. Sometimes the muscles on the back may be divided as part of the procedure. A muscle-sparing incision may be used, or a minimally invasive approach such as video or robot-assisted operation may be possible. If you are about to undergo surgery for lung cancer it is important to ask your surgeon about these approaches and what is best for you.
As part of the operation for removal of a non-small cell lung cancer surgeons perform a lobectomy, removing a portion of a lung. Occasionally a pneumonectomy, removing the entire lung, may be performed. Once the portion of the lung with the tumor has been removed, the surgeon removes the lymph nodes that receive drainage from the lung. The lymph nodes are examined to determine if the tumor has spread to them; this information will affect the staging of the tumor and hence the prognosis.
After the surgery has been completed, the surgeon will insert one or two chest tubes (drains). These will allow air and fluid to drain out of the chest in the days after the procedure. Once the drainage has decreased, the surgeon will remove the drain. The epidural, if there is one, will be removed. Most patients go home after four or five days in the hospital with the open technique, or 3 days with a video-assisted procedure. While in the hospital, it is important to work on deep breathing and coughing. As with any procedure, there are risks associated with every type of operation. Before having any surgery, make sure you have discussed the potential risks and benefits of your operation your surgeon.