Lung Resection

What is a lung resection?

A lung resection, also called a pulmonary resection, is surgery to remove part or all of your lung. Surgeons remove part of your lung that’s damaged or diseased from cancer, infections or inflammation. Healthcare providers can also use it to get tissue samples to diagnose lung conditions (biopsy).

You have two lungs. Each is divided into sections called lobes — you have two lobes in your left lung and three in your right. A lung resection can remove an entire lobe, parts of a lobe or the entire lung. Lung resection is a major surgery, but you can live with only one lung or with part of a lung removed.

Types of lung resection

Types of lung resection include:

• Wedge resection. A surgeon removes a wedge-shaped section of lung tissue.
• Segmentectomy. A surgeon removes one to four portions of a lobe of your lung while preserving the rest.
• Lobectomy. A surgeon removes one lobe of your lung. A sleeve resection is a type of lobectomy where a surgeon removes part of your lung and main bronchus (airway). Then, they reattach the main bronchus to the remaining, healthy lobe.
• Bilobectomy. A surgeon removes two lobes of your right lung.
• Pneumectomy. A surgeon removes your entire lung.
• Lung volume reduction surgery. A surgeon removes pockets in your lungs that contain trapped air.

What does a lung resection treat?

Healthcare providers perform a lung resection to treat:

• Lung cancer (stages I, II and sometimes III)
• Cancer that has spread to your lungs from other organs (metastatic cancer)
• Benign lung tumors or lung nodules
• Bronchiectasis
• Emphysema
• Abscesses
• Lung injuries (blunt force or penetrating trauma)

Healthcare providers may use a lung resection to get tissue samples. These samples can help them to diagnose:

• Cancer
• Tuberculosis or other lung infections
• Lung nodules
• Pulmonary fibrosis and other inflammatory lung diseases

How does a lung resection work?

A surgeon can use one of two types of surgery for a lung resection:

• Thoracoscopic surgery. Video-assisted thoracoscopic surgery (VATS) or robotic video-assisted thoracoscopic surgery (RVATS) are two types of minimally invasive procedures that surgeons use for lung resections. Your provider can make smaller incisions and use instruments through a thoracoscope (lighted tube with a camera on the end) or a robotic arm to perform the surgery.
• Open surgery (thoracotomy). Open surgery is more involved than thoracoscopic surgery. A surgeon makes an incision in your side and spreads your ribs apart to perform a thoracotomy.

How do I prepare for a lung resection?

Your provider will give you instructions on how to prepare for lung resection. Following their directions closely can reduce your risk of complications. Tell your healthcare provider about any medications you take, including supplements, and if you have an implanted medical device (like a joint replacement, artificial heart valve or pacemaker).

Before a lung resection, you may need to:

• Not eat or drink anything (fast) for a certain amount of time before the procedure
• Not take certain medications or alter your medication schedule (don’t stop taking medications unless your provider tells you to)
• Stop smoking (if you do)
• Arrange to spend several days at the hospital and for someone to drive you home
• Get testing or imagining

What tests will I need before lung resection?

Depending on why you’re getting a lung resection, you might need to get a few tests or imaging before the procedure. These include:

• Blood tests
• Lung (pulmonary) function tests
• Chest X-ray
• CT (computed tomography) scans
• Heart tests, such as an electrocardiogram or an exercise stress test
• MRI (magnetic resonance imaging)
• PET (positron emission tomography) scan
• Bronchoscopy

What happens during the procedure?

What happens during lung resection depends on:

• Whether your surgeon is using minimally invasive techniques or open surgery
• How much of your lung your surgeon is removing
• What condition your provider is diagnosing or treating
• What technique they’re using

Generally, during lung resection:

• You’ll be under general anesthesia (asleep).
• Your provider will make an incision or multiple incisions in your chest or side.
• For thoracotomy or sternotomy, your surgeon will separate your ribs to remove tissue. For VATS or RVATS, your surgeon will insert a thoracoscope (tube with a light and small camera) into your chest. They’ll perform the procedure with long, thin instruments.
• Your provider will insert a drain tube into your chest to drain excess fluid.
• Your provider will close the incision.

How long does a lung resection take?

Lung resection can take three to six hours depending on your specific circumstances.

What happens after a lung resection?

After lung resection, your care team will take you to a recovery room, where you’ll begin to wake up. You can typically expect to spend about two to three days in the hospital. But the length of your hospital stay depends on the type of surgery you had and how well you’re recovering.

Most people will need chest tubes for 24 to 48 hours after their surgery, but sometimes, they stay in longer.

What are the advantages of a VATS or RVATS lung resection?

People who have VATS or RVATS instead of thoracotomy tend to have:

• Less pain
• Fewer complications
• Shorter recovery time and faster return to all activities

What are the risks or complications of a lung resection?

Like all surgeries, lung resections come with the risk of complications. Possible complications include:

• Air leak
• Irregular heartbeat (arrhythmia)
• Bronchopleural fistula (an abnormal passageway in your lungs)
• Bleeding in your chest (hemothorax)
• Pneumonia
• Infections at the incision site
• Blood clots in your lungs (pulmonary embolism)
• Reactions to anesthesia

What can I expect if I’ve had a lung resection?

If you have a thoracotomy, you’ll usually need to limit your activity for about a month. People who have VATS or RVATS often return to their regular activities in two weeks. Your healthcare provider will give you instructions on what activities are safe and what to limit.

You may feel short of breath after your surgery. Your healthcare providers may teach you coughing or deep breathing exercises to help keep your lungs clear. You may need supplemental oxygen for a short time to help with your recovery.

You may also notice some swelling in your legs. If you notice that this worsens after you go home, contact your surgeon.

How long does it take to recover?

Your recovery after a lung resection can take anywhere from weeks to months. How fast you recover depends on:

• The type of resection you had
• Your overall health
• Whether you had open or minimally invasive surgery
• Other medical conditions you have

How can I take care of myself after lung resection?

The best way to take care of yourself after a lung resection is to follow your provider’s instructions for keeping your lungs clear and how to safely return to normal activities. Drink plenty of fluids to keep your bowel movements (pooping) regular and avoid constipation. If your bowel movements aren’t regular, ask your provider about fiber supplements.

What’s the mortality rate for lung resection?

The mortality (death) rate for lung resection varies by what kind of resection, what condition it’s treating, overall health and other factors. Generally, the more tissue a surgeon removes, the higher the mortality. For example, studies suggest pneumonectomy for lung cancer has a mortality rate of around 5%, while wedge resections have a mortality rate of less than 1%. Keep in mind that these numbers only include mortality during or soon after the surgery.

When should I call my healthcare provider?

Contact your healthcare provider right away if you have any of these symptoms after your surgery:

• Blood that soaks through your incision bandage
• Coughing up excessive mucus or discolored mucus
• Discolored or foul-smelling fluid around the incisions
• Fever
• Nausea or vomiting
• Pain that medication doesn’t help

Call 911 or go to the nearest emergency room if you:

• Cough up blood
• Have unexpected difficulty breathing
• Have sudden chest pain with shortness of breath
• Lose consciousness

Can a lung resection cure cancer?

Lung resections are most effective for treating early-stage non-small cell lung cancers (that haven’t spread outside your lung) and carcinoid tumors (a type of slow-growing cancer). But providers can’t predict whether it will completely cure you. You may need chemotherapy or radiation after a lung resection to treat cancer.

Do lungs grow back after resection?

No, lung tissue heals but doesn’t grow back after surgery (unlike your liver, which can grow back to most of its normal size after removing part of it).