Lung cancer surgery
Encyclopedia
Lung cancer surgery describes the use of surgical operations
in the treatment
of lung cancer
. It involves the surgical excision of cancer tissue from the lung. It is used mainly in non-small cell lung cancer with the intention of curing the patient.
, location and cell type are important limiting factors. In addition, patients who are very ill with a poor performance status
or who have inadequate pulmonary reserve would be unlikely to survive. Even with careful selection, the overall operative death rate is about 4.4%.
" refers to the degree of spread of the cancer.
See non-small cell lung cancer staging
In non-small cell lung cancer, stages IA, IB, IIA, and IIB are suitable for surgical resection.
. If there is no evidence of undue shortness of breath or diffuse parenchymal lung disease
, and the FEV1 exceeds 2 litres or 80% of predicted, the patient is fit for pneumonectomy
. If the FEV1 exceeds 1.5 litres, the patient is fit for lobectomy.
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
in the treatment
Management of cancer
Cancer can be treated by surgery, chemotherapy, radiation therapy, immunotherapy, monoclonal antibody therapy or other methods. The choice of therapy depends upon the location and grade of the tumor and the stage of the disease, as well as the general state of the patient...
of lung cancer
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...
. It involves the surgical excision of cancer tissue from the lung. It is used mainly in non-small cell lung cancer with the intention of curing the patient.
Patient selection
Not all patients are suitable for operation. The stageCancer staging
The stage of a cancer is a description of the extent the cancer has spread. The stage often takes into account the size of a tumor, how deeply it has penetrated, whether it has invaded adjacent organs, how many lymph nodes it has metastasized to , and whether it has spread to distant organs...
, location and cell type are important limiting factors. In addition, patients who are very ill with a poor performance status
Performance status
In medicine , performance status is an attempt to quantify cancer patients' general well-being and activities of daily life. This measure is used to determine whether they can receive chemotherapy, whether dose adjustment is necessary, and as a measure for the required intensity of palliative care...
or who have inadequate pulmonary reserve would be unlikely to survive. Even with careful selection, the overall operative death rate is about 4.4%.
Stage
"StageCancer staging
The stage of a cancer is a description of the extent the cancer has spread. The stage often takes into account the size of a tumor, how deeply it has penetrated, whether it has invaded adjacent organs, how many lymph nodes it has metastasized to , and whether it has spread to distant organs...
" refers to the degree of spread of the cancer.
See non-small cell lung cancer staging
Non-small cell lung cancer staging
Non-small-cell lung carcinoma is any type of epithelial lung cancer other than small cell lung carcinoma . As a class, NSCLCs are relatively insensitive to chemotherapy, compared to small cell carcinoma...
In non-small cell lung cancer, stages IA, IB, IIA, and IIB are suitable for surgical resection.
Pulmonary reserve
Pulmonary reserve is measured by spirometrySpirometry
Spirometry is the most common of the pulmonary function tests , measuring lung function, specifically the measurement of the amount and/or speed of air that can be inhaled and exhaled...
. If there is no evidence of undue shortness of breath or diffuse parenchymal lung disease
Diffuse parenchymal lung disease
Interstitial lung disease , also known as diffuse parenchymal lung disease , refers to a group of lung diseases affecting the interstitium ....
, and the FEV1 exceeds 2 litres or 80% of predicted, the patient is fit for pneumonectomy
Pneumonectomy
A pneumonectomy is a surgical procedure to remove a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a wedge resection .-Indications:...
. If the FEV1 exceeds 1.5 litres, the patient is fit for lobectomy.
Types of surgery
- LobectomyLobectomy (lung)Lobectomy of the lung is a surgical operation where a lobe of the lung is removed. It is done to remove a portion of diseased lung, such as early stage lung cancer.See also: Lung volume reduction surgery...
(removal of a lobe of the lung) - Segmentectomy (removal of an anatomic division of a particular lobe of the lung)
- PneumonectomyPneumonectomyA pneumonectomy is a surgical procedure to remove a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a wedge resection .-Indications:...
(removal of an entire lung) - Wedge resectionWedge resection (lung)Wedge resection of the lung is a surgical operation where a part of a lung is removed. It is done to remove a localized portion of diseased lung, such as early stage lung cancer....
- Sleeve/bronchoplastic resection (removal of an associated tubular section of the associated main bronchial passage during lobectomy with subsequent reconstruction of the bronchial passage)
- VATS lobectomyVATS lobectomyVideo-assisted thoracoscopic surgery lobectomy is an approach to lung cancer surgery.-Traditional approach to lung cancer surgery: thoracotomy:Anatomic lung resection, i.e...
(minimally invasive approach to lobectomy that may allow for diminished pain, quicker return to full activity, and diminished hospital costs)