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Thoracic Surgery for Lung Cancer

Thoracic surgery remains the preferred treatment of lung cancer for curative intent. Surgery as a treatment option for lung cancer depends on the type and stage of cancer, as well as the overall health of the patient. The surgeon will want to know how well a patient's lung is functioning. This information will tell the surgeon how much lung tissue can be removed and how well the patient can expect to function after surgery.

Most often, a lobectomy-removal of a whole lobe of the lung is the operation performed with the goal to cure lung cancer. Sometimes an entire lung has to be removed in an operation and this is called pneumonectomy. A wedge resection-removal of a section of the lobe with the tumor can be performed if the surgeon doesn't feel a patient can tolerate a lobectomy.

Very often, if lung cancer is suspected, but a biopsy (tissue sample taken for examination) could not be performed prior to surgery, a wedge resection can be performed. The tissue can be sent to the pathologist for examination while the patient is still in surgery. If the pathologist sees that it contains cancer, the surgeon will go on to perform a lobectomy.

When the surgeon removes the tumor, he or she will remove lymph nodes in the chest to determine whether the cancer has spread. This information helps with staging the cancer.

These operations are most often performed through an incision made at the side of the chest between the ribs, sometimes with a small portion of rib being removed. This incision of the chest wall is called a thoracotomy.

Sometimes the lung surgery can be performed via a minimally invasive procedure called thoracoscopy. Three smaller incisions are used.

Your surgeon will discuss any complications that have occurred during or after your surgery. These can include infection, bleeding, and shortness of breath. You can expect to have a fair amount of pain, for which medications will be given to you to help control it.

Very often, a catheter (thin tube) is inserted in your back just prior to the surgery, and is used as a way to give you medication to control the pain while you are in the hospital. This method of pain management is commonly called an epidural.

Our surgeons have very favorable five-year results compared to national data. The procedures performed by our surgeons include:

Pneumonectomy: A procedure in which the surgeon removes an entire lung containing lung cancer.

Lobectomy: A procedure in which the surgeon removes a lobe of the lung that has cancer.

Video-assisted thoracic surgery (VATS) lobectomy: A minimally invasive procedure for removing lung cancer when characteristics of the tumor allow for it. Some early-stage tumors may be treated with VATS, which uses several small incisions (instead of 1 large one) and special long surgical tools.

Wedge resection: A procedure in which the surgeon removes a small wedge-shaped piece of lung that contains lung cancer and a margin of healthy tissue around the cancer. This is likely to be done when the patient's lung function would be decreased too much by a lobectomy.

Thoracoscopy: A procedure in which a small cut is made in the side of the chest wall through which a small tube with a video camera on the end is inserted. This allows the surgeon to look at the outer part of the lungs and chest wall and to sample any abnormal areas for viewing under a microscope.

Mediastinoscopy: A process in which a small cut is made in the neck so that a tissue sample can be taken from the lymph nodes (mediastinal nodes) along the windpipe and the major bronchial tube areas to evaluate under a microscope.

For more online information about thoracic surgery for lung cancer, please visit our Lung Cancer Evaluation Center and our Health Information Library