Pulmonary Lobectomy Tunisia
What is pulmonary lobectomy?
A lobe of the lung is removed in a surgical procedure known as a pulmonary lobectomy. Removal of a lung tumor is the most common procedure. The treatment lasts from 1.5 to 6 hours. After surgery, it will be necessary to restore respiratory capacity by performing physiotherapy exercises and continuing regular physical activity. Smokers should quit smoking completely. The goal of pulmonary lobectomy is to remove a lobe of the lung, which can be one of the three lobes on the right or one of the two lobes on the left.
Since the lung does not regenerate, complementary mechanisms will be used to fill the removed lobe. This involves a greater expansion of the remaining lung parenchyma, a slight rise of the diaphragmatic dome and a slight deviation of the midorgans towards the operated side. In addition to this lobectomy, all of the lymph nodes that drain the lung on the operated side are also removed. An operation called pulmonary lobectomy makes it possible to remove localized cancer, a benign tumor, or even specific lesions of infectious origin. Pulmonary lobectomy is an uncommon procedure today. It involves the complete removal of the lung where the tumor is located. It can also be a complete section of one of the two lungs.
How does the surgery take place?
Removal of a lung tumor is the most common procedure. The treatment lasts from 1.5 to 6 hours. After surgery, it will be necessary to restore respiratory capacity by performing physiotherapy exercises and continuing regular physical activity. Smokers should quit smoking completely.
What are the indications?
Indications for pulmonary lobectomy are mainly related to the resection of a lung tumor and the area of the lung near the tumor. The treatment of a destroyed lung lobe, superinfected by rare germs or presenting an indeterminate tumor also requires a pulmonary lobectomy. Finally, this technique can be used to remove metastases or pulmonary nodules of undetermined origin.
What are the types?
Lung lobectomies are initially performed by two main routes: thoracotomy, also known as open surgery, and thoracoscopy. An open surgical procedure that involves opening the chest and removing the lobe of the lung affected by the tumor is called thoracotomy. In contrast, thoracoscopic lung lobe removal is a less invasive method that uses minimally invasive techniques.
There are mainly two types of pulmonary lobectomy: simple lobectomy and bilobectomy. Simple lobectomy removes one lobe of the lung, while bilobectomy removes two lobes of the lung. Bilobectomy may be performed for medical reasons, such as the presence of two tumors in the same lung, or for technical reasons, such as difficulty in easily accessing the tumor using a thoracoscopic technique.
What are the advantages ?
A tumor or lobe destroys the lung.
After the intervention, respiratory function was improved.
Reduce the risk of cancer or tumor recurrence.
What are the disadvantages ?
An invasive surgical procedure that often involves opening the chest.
Risk of lung infections, bleeding and prolonged pain after surgery.
Respiratory physiotherapy and nutrition before the operation to eliminate bronchial secretions.
After the operation, a stay in the clinic and convalescence are necessary.
What are the possible complications afterwards?
Lung problems such as pneumonia, retained secretions, lung infections, and persistent pain can be potential complications after a pulmonary lobectomy. Heart rhythm problems and other heart complications may also occur. Bleeding, wound infections, chest pain, breathing problems, blood clots, and allergic reactions to anesthesia are other possible complications.
How long does recovery take after surgery?
Recovery after pulmonary lobectomy can vary depending on many factors, including the patient's general health, the surgical technique used, and the presence of postoperative complications. Patients can usually expect to stay in the hospital for about a week after their surgery. A recovery period is necessary after hospitalization to allow the body to heal and get back on its feet. For several weeks after surgery, patients may experience pain, fatigue, and difficulty breathing.
To help clear bronchial secretions and improve lung function, chest physiotherapy is often recommended. To strengthen muscles and improve respiratory function, patients may be encouraged to return to regular physical activity. Patients can usually expect to return to normal lung function within three months after surgery.
Are there any alternatives to this surgery?
Yes, alternatives to pulmonary lobectomy exist. For patients with lung cancer, thoracoscopy lobectomy is considered an alternative to thoracotomy lobectomy. Another alternative is lobectomy combined with resection and anastomosis of the lobar bronchus. Patients who could benefit from less invasive methods may find surgical alternatives.
What are the criteria to be eligible for a pulmonary lobectomy?
Conditions to be eligible for a pulmonary lobectomy generally include:
Diagnosis of non-small cell lung cancer, such as squamous cell carcinoma, lung adenocarcinoma or neuroendocrine tumor.
There are no widespread metastases.
Good lung function and tolerance to lung resection
The absence of significant contraindications to surgery, such as serious lung or heart problems.
Ability to undergo preoperative preparation, including smoking cessation, chest physiotherapy and nutritional support.
What is the success rate?
Several factors influence the success rate of pulmonary lobectomy, including the stage of the cancer, the patient's general health, and the presence of postoperative complications. Available data indicate that approximately 70% of lobectomy patients survive five years. However, the prognosis after lobectomy depends on several factors, including the characteristics of the cancer, the presence of metastases, and the response to postoperative treatment. Postoperative complications of pulmonary lobectomies can include prolonged air leaks, pneumonia, and arrhythmias, with an overall complication rate estimated between 5 and 10%.
What are the differences between an open pulmonary lobectomy and a video-assisted pulmonary lobectomy (VATS)?
To access the lung and remove the affected lobe, a surgical procedure called open pulmonary lobectomy, or thoracotomy, requires a large chest incision. Video-assisted pulmonary lobectomy (VATS), on the other hand, is a less invasive method that uses a camera and small incisions to examine and extract the lobe of the lung. The benefits of VATS include faster recovery, reduced postoperative pain, and reduced risk of complications compared to thoracotomy. According to studies, thoracoscopic lobectomy is a safe method that results in fewer complications and faster recovery.
Are there any long term side effects?
Long-term side effects of pulmonary lobectomy may include lung problems such as pneumonia, retained secretions, and heart complications such as rhythm disturbances. However, lobectomy does not cause disability. People who have normal lung function can recover it as early as three months after a lobectomy, provided they perform chest physiotherapy appropriately.
How long does one live after a pulmonary lobectomy?
Lifespan after pulmonary lobectomy depends on many factors, such as the patient's general health, the nature of the disease, the stage of the cancer, the presence of metastases, and the response to postoperative treatment. There is no precise answer to this question. However, available data indicate that approximately 70% of lobectomy patients survive five years.
What is the difference between a pulmonary lobectomy and a pneumonectomy?
Two surgical procedures involving the removal of lung tissue are pulmonary lobectomy and pneumonectomy, but the extent of resection differs.
The surgical removal of a lobe of the lung is called pulmonary lobectomy. Treatment of non-small cell lung cancer, such as squamous cell carcinoma, lung adenocarcinoma, or neuroendocrine tumor, is most often done with this procedure. It can be done either through open surgery called a thoracotomy or by video-assisted surgery called thoracoscopy.
The total removal of one of the lungs by surgery is called pneumonectomy. Certain types of diseases that cannot be treated with resection, such as large tumors or serious infections, are treated with this procedure. If the patient's cardiorespiratory functions are normal, pneumonectomy can be performed without noticeable effects. on his daily life.