Type of Surgery
Information
Last updated: 02/17/2009
Diagnosis
In some cases, the diagnosis of a lung disorder is made when the patient consults a physician about chest pains or other symptoms. The symptoms of lung cancer vary somewhat according to the location of the tumor; they may include...
persistent coughing, coughing up blood, wheezing, fever, and weight loss. In cases involving direct trauma to the lung, the decision to perform a pneumonectomy may be made in the emergency room. Before scheduling a pneumonectomy, however, the surgeon reviews the patient's medical and surgical history and orders a number of tests to determine how successful the surgery is likely to be.
In the case of lung cancer, blood tests, a bone scan, and computed tomography scans of the head and abdomen indicate whether the cancer has spread beyond the lungs. Positron emission tomography (PET) scanning is also used to help stage the disease. Cardiac screening indicates how well the patient's heart will tolerate the procedure, and extensive pulmonary testing (e.g., breathing tests and quantitative ventilation/perfusion scans) predicts whether the remaining lung will be able to make up for the patient's diminished ability to breathe.
Preparation
A patient who smokes must stop as soon as a lung disease is diagnosed. Patients should not take aspirin or ibuprofen for seven to 10 days before surgery. Patients should also consult their physician about discontinuing any blood-thinning medications such as coumadin or warfarin. The night before surgery, patients should not eat or drink anything after midnight.
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Other Information
A pneumonectomy (or pneumectomy) is a surgical procedure to remove a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a wedge resection (or segmentectomy).
The most common cause for a pneumonectomy is to excise tumourous tissue arising from lung cancer. Other indications for lobectomy include a solitary pulmonary nodule (the possibility of undiagnosed small-cell cancer in this instance is not necessarily a reason for avoiding thoracotomy), or bronchiectasis where other forms of treatment have failed, particularly if it is localised and recurrent hemoptysis is present. In the days prior to the use of antibiotics in tuberculosis treatment, tuberculosis was sometimes treated surgically by pneumonectomy.
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