Lobectomy and bilobectomy are surgical options for treating early-stage non-small cell lung cancer (NSCLC).

What is a lobectomy?

The lungs are split into large sections called lobes. The right lung is made up of three lobes, and the left two.

A lobectomy involves removing a lobe that contains a tumor. If the cancer cells have not started to spread, a lobectomy can cure lung cancer.

If the cancer is so large that two lobes need to be removed, the procedure is called a bilobectomy.

When is lobectomy recommended?

In general, a lobectomy is one of the first treatment options for NSCLC if a diagnosis has been made early enough.

If the cancer has become metastatic — that is, has spread to other parts of the body — doctors will not perform a lobectomy because it wouldn’t cure the cancer.

Doctors generally prefer lobectomy over segmentectomy, or removing only a section of a lobe, because it provides a greater chance of eliminating the cancer.

Before the surgery

Before surgery, doctors determine whether a patient’s health is good enough to withstand an operation.

This includes taking x-rays and performing blood, heart-function and lung-function tests to ensure that surgery would not present too high a risk to the patient’s health. Doctors are also likely to check whether the patient might have an adverse reaction to anesthesia.

During the surgery

In general, a lobectomy is thoracotomy or open-chest surgery. But doctors can decide instead on video-assisted thoracic surgery, also known as keyhole surgery. Either surgery is carried out under anesthesia.

Thoracotomy involves a surgeon opening the side of the chest with the cancerous lobe. The surgeon spreads the ribs to gain access to the lobe and remove it. The size of the incision the surgeon makes to gain access to the lobe depends on the size and location of the tumor.

Keyhole surgery has less impact on the body because the size of the surgical opening is smaller. In addition, the recovery time is shorter than with a thoracotomy.

Keyhole surgery is more difficult to perform, however. Surgeons make a number of small incisions so they can insert a thoracoscope — a thin tube with a fiberoptic camera attached — and surgical instruments into the chest cavity.

After the surgery

After the surgery, an IV is used to supply a patient with liquids and nutrients while they recover. In addition, doctors attach a tube to the site of the patient’s surgery to siphon off excess air and fluid. This is temporary.

Medical professionals may have to teach a patient deep breathing and coughing methods to help them re-expand the lungs after surgery. Patients may also need oxygen for a while.

Doctors will carefully monitor the surgical wound for signs of infection. They may also prescribe pain medication during recovery. They usually encourage patients to move around as soon as they can to speed the healing process.

What are the risks associated with lobectomy?

All surgery carries some risk, and lobectomy is no exception.

Complications during surgery can lead to the formation of blood clots, excessive bleeding, and pneumonia. Patients can also react badly to the anesthetic.

In addition, there is also a risk of infections developing after the surgery.

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