A wedge resection is a procedure that involves the surgical removal of a small, wedge-shaped piece of lung tissue to remove a small tumor or to diagnose lung cancer.
It is an ideal procedure for the treatment of certain types of lung cancer, especially non-small cell lung cancer (NSCLC) requiring the removal of small lesions of cancer cells, also known as lung nodules. However, the nodules cannot be embedded deep within the lung tissue for this surgery.
A wedge resection is also preferred for patients who cannot tolerate the removal of a large-sized section of the lung when there may be a significant decrease in lung function. Therefore, wedge resection may be performed as an alternative to lobectomy, a procedure in which an entire lobe is removed from the lung. This surgery is performed if the cancer is contained within a small area.
A wedge resection is often done in conjunction with chemotherapy and/or radiation therapy.
Before wedge resection
Prior to the surgery, it is highly recommended that the patient participates in daily light exercises, such as walking.
The patient is advised to quit smoking before surgery if the surgery is more than two weeks away. A physician can provide information about smoking cessation strategies and support groups.
Blood-thinning medications, such as warfarin, must be stopped at least five days before the procedure. Diabetes medications should be reduced to half their dose. The patient cannot eat or drink anything the night before the procedure, usually starting at midnight.
Wedge resection procedure
Depending on the location of the tumor and other factors, wedge resection can be performed either by video-assisted thoracoscopic surgery (VATS) or by a thoracotomy (open chest surgery).
While thoracotomy involves a long (six to 10 inch) incision in the chest, VATS is less invasive with a few small incisions made during surgery.
The minimally invasive VATS procedure begins with an examination of the windpipe using a bronchoscope, which is a flexible tube fitted with a camera. A small cut is then made between the ribs, through which a small camera is inserted into the chest for inspection. To locate the lesion or nodule, additional small cuts are made.
The surgeon removes a small piece of the lung tissue that contains the nodule using special staplers, which are designed to tightly seal the remaining lung tissue. Next, the cuts are closed and a small flexible plastic tube is inserted into the chest to drain any fluid or air. The chest tube is usually removed after the lung has expanded.
Finally, the lung is inspected to make sure it expands properly, the stitches are dissolved, and a liquid plastic dressing is used over the incisions.
After wedge resection
It is very important to walk and perform breathing exercises before and after the surgery to help prevent pneumonia and blood clots. The chest tube is removed once the lung tissue has healed and stops leaking air, which usually happens within 24 to 48 hours after surgery. Recovery typically takes a week. The patient is closely monitored after treatment by a care team to address any issues that arise after the treatment.
Support from friends and family will increase the patient’s chances for a prompt and successful recovery.
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