Lung Lobectomy

What you should know

• Lung lobectomy is a type of thoracotomy surgery done to remove one or more lobes of your lung. Your lungs are two hollow organs that are covered by pleural sacs (two thin layers of tissue). Each lung is divided into lobes (sections) by deep grooves. Normally, your right lung has three lobes while your left lung has two lobes. Lung lobectomy is usually done to treat lung tumors, infections including abscesses (pus), or lung damage. With lobectomy, your caregiver will cut and remove only one lobe of your lung. If two lobes of the right lung are removed, the surgery is called bilobectomy. Your caregiver leaves one or two lobes of the lung in place to allow for normal lung function.
  
  
• During lobectomy, your caregiver may rejoin the airways he had cut and reattach them to the remaining lobes. This is called sleeve lobectomy. This is often done if a tumor is in the center part of your lungs. Your caregiver may also reattach the cut arteries along with the cut airways. This is called a double sleeve technique. Other parts in the area may also be removed, aside from the lung lobe. These include lymph nodes (glands) between the lobes, chest muscles, tissue lining of your heart, or diaphragm. You and your caregiver will decide which lobectomy technique is best for you.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

• During your lung lobectomy, you may bleed more than usual. You may have trouble breathing or get pneumonia afterwards. Other organs or tissues near your lung may be damaged or you may get an infection. You may have pain, which may make it hard for you to breathe well. Air and fluid may leak from the lung that was opened. When this happens, your chest tube may need to stay in place for a longer time. You may also need to stay in the hospital longer. People who smoke or have a heart disease are at higher risk for having problems.
  
  
• You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs or brain. A blood clot in your lungs can cause chest pain and trouble breathing. A blood clot in your brain can cause a stroke. These problems can be life-threatening.
  
  
• Without this surgery you may have other problems. You will need more tests to find the cause of your condition, which may take longer than having lobectomy. It may also be harder to find the exact cause of your condition. You may have lung cancer and not know it as soon. The cancer cells may spread or your condition may become worse, and you may die. Call your caregiver if you are worried or have questions about your surgery, condition, or care.

Getting Ready

The week before your surgery:

• Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.
  
  
• If you smoke, your caregiver may tell you to stop smoking for at least 2 to 3 weeks before your surgery.
  
  
• Your caregiver may have you start using an incentive spirometer before your surgery. This is a device that improves your breathing by having you take in deep breaths.
  
  
• You may need to have blood tests, urine tests, electrocardiogram (ECG), chest x-ray, and computed tomography (CT) scan. You may also be asked to have exercise stress tests, pulmonary function tests, and an arterial blood gas (ABG) test. These tests check how well your heart and lungs work. Ask your caregiver for more information about these and other tests that you may need. Write down the date, time, and location of each test.

The night before your surgery:

• Ask caregivers about directions for eating and drinking.
  
  

The day of your surgery:

• Write down the correct date, time, and location of your surgery.
  
  
• Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.
  
  
• Your caregiver may put a catheter (thin tube) through your back into your spine. This is called an epidural catheter. Pain medicine may be put through the catheter.
  
  
• An anesthesiologist may talk to you before your surgery. This caregiver may give you medicine to make you sleepy before your procedure or surgery. Tell your caregiver if you or anyone in your family has had a problem using anesthesia in the past.
  
  
• You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

Treatment

What will happen:

• You will be taken to the room where your surgery will be done. Medicine called anesthesia will be given to keep you asleep and free from pain during the surgery. Special IV (intravenous) lines used to show how you are doing during surgery may be inserted. You will lie on your side. Your chest area will be cleaned and sheets will be put over you to keep the area clean. During your surgery, an incision (cut) will be made so that caregivers can work on your chest.
  
  
• After opening your chest, your ribs may be cut or spread apart to see your lung better. Arteries, veins, and airway tubes are clamped and cut and the lobe is removed. Your airways are tightly sewn together and may be reattached to your remaining lobes. Your arteries may also be reattached to the remaining lobe. A chest tube will be put inside your chest to drain blood and fluid. Your incision will be closed using a strong wire, stitches (thread), or staples. Your lung lobe may be sent to the lab for tests.

After your surgery:

You will be taken to the recovery room or your hospital room, which may be in intensive care. Your caregiver will check you often, and you may be on monitors that your caregivers watch outside your room. Do not try to get out of bed until your caregiver says it is OK. A bandage may cover your stitches or staples to keep the area clean and dry to prevent infection. A breathing tube may be left in your mouth and throat for a day or two after surgery. The tube may be hooked up to a machine called a ventilator, which will breathe for you. You may need to stay in the hospital for 5 to 7 days after your surgery.

Waiting area:

This is an area where your family and friends can wait until you are able to have visitors. Ask your visitors to provide a way to reach them if they leave the waiting area.

Contact a caregiver if

• You cannot make it to your surgery on time.
  
  
• You get sick (a cold or the flu).
  
  
• You have questions or concerns about your surgery.

Seek Care Immediately if

• You have a fever.
  
  
• The problems for which you are having the lobectomy get worse.
  
  
• You have trouble breathing all of a sudden, or your heart is beating faster than normal.
  
  
• You vomited (throw up) blood.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.