Lung cancer surgery may be an option at the early stages of the disease. Where possible, it may be a way to cure non-small cell lung cancer (NSCLC), along with other treatments.
After deciding that surgery is the best option for lung cancer treatment, doctors will perform pulmonary function tests (PFTs) to check whether there will be enough healthy lung tissue left after the removal of the cancerous tissue. These tests are noninvasive and show how well the lungs are working by measuring lung volume, capacity, rates of air flow, and gas exchange. Other tests include heart and other organ function tests to assess the patient’s general state of health.
The operation is usually performed under general anesthesia through a surgical incision between the ribs on the side of the chest where the tissue to be removed is situated.
Types of lung surgery
The type of surgery depends on the size, type, and location of the tumor. It is common for doctors to perform an extensive procedure as it may have a greater chance of curing the cancer. The nearby lymph nodes are usually removed as well to check for the possible spread of cancer. This is called lymphadenectomy.
There are different kinds of lung surgery that can be performed:
- Pneumonectomy, where the entire lung is removed. Usually, this is needed when the cancer is close to the center of the chest.
- Lobectomy, where the lobe containing the tumor is removed. The lungs have five lobes, three on the right and two on the left side. A lobectomy is the preferred type of surgery whenever possible.
- Bilectomy, where two lobes of the lung are removed.
- Segmentectomy, where only a part of a lobe is removed. This is done when the lung function is already compromised
- Wedge resection, where a small area of the lung is removed
- Sleeve resection, where the section of the airway that contains the cancer is removed to preserve lung function.
Surgeons are starting to treat early-stage cancers that are in the outer parts of the lung through video-assisted thoracic surgery (VATS), also called keyhole surgery, where a thin, rigid tube with a video camera on the end is placed through a small cut on the side of the chest to help the surgeon see inside the chest. Then, one or two cuts are made to remove the tumor. This surgery is associated with less pain and a shorter hospital stay.
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