Lung surgery (thoracotomy) for lung cancer

Surgery to remove all or part of a lung involves making a cut on one side of your chest (thorax) during a procedure called a thoracotomy. Surgery that uses this approach avoids areas in the chest that contain the heart and the spinal cord.

After the cut is made between the ribs, all or part of the lung is removed depending on the location, size, and type of lung cancer that is present. See illustrations of:

• Normal anatomy of the lungs and respiratory system .
• Lung cancer . Lung cancer is the rapid growth of abnormal cells in the lung tissue.
• Lung surgery (thoracotomy) . The types of lung surgery are:
  • Wedge resection (segmentectomy). The surgeon removes a small wedge-shaped piece of lung that contains the lung cancer and a margin of healthy tissue around the cancer. This is likely to be done when your lung function would be decreased too much by removing a lobe of lung (lobectomy). The risk of lung cancer coming back (recurring) is higher with this method.
  • Lobectomy. The right lung has three lobes and the left lung has two lobes. A lobectomy removes the entire lobe of your lung that contains the cancer. Your lungs can function with the lobes that remain.
  • Pneumonectomy. A pneumonectomy removes your entire lung that contains the lung cancer. A pneumonectomy is done only when necessary because it will greatly reduce your overall lung function.
• Chest tube . A chest tube is used after lung surgery to drain fluid and blood out of your chest cavity and help your lung refill with air.

A video-assisted thoracoscopic surgery (VATS) may be done before or instead of a thoracotomy. This procedure involves inserting a long, thin tube (videoscope) with a camera attached and small surgical instruments into your chest through small cuts made between your ribs. The VATS method may be used to:

• Confirm the diagnosis of lung cancer.
• Biopsy lymph nodes in the center part of your chest (mediastinum).
• Perform a wedge resection of your lung cancer. This removes the cancer and the lung tissue surrounding the cancer.
• Remove the segment (lobe) of the lung that contains the cancer, in some cases. Your lungs are divided into parts called lobes. Your right lung has 3 lobes, and your left lung has 2 lobes. Removing a whole lobe is called a lobectomy.

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