Bilobectomy
Bilobectomy is a surgical procedure that involves the removal of two contiguous lobes from the right lung, often performed to treat various types of lung cancer. This operation is usually undertaken when lung tissue is diseased and is aimed at improving the patient's health by eliminating cancerous or damaged areas. The surgery is conducted under general anesthesia, with thorough preoperative evaluations including physical exams and consultations with specialists.
During the procedure, a thoracic surgeon makes an incision in the side of the chest, separates the rib cage, and removes the affected lobes while managing the remaining lung with a breathing tube. Post-operative care includes pain management, breathing exercises, and a hospital stay of about one week, with a home recovery period that may last several weeks.
While bilobectomy can be effective, particularly for early-stage non-small-cell lung cancer, it carries risks such as airway narrowing, nerve injury, and potential complications from blood clots. Smoking cessation is critical for optimal recovery and overall outcomes, especially when combined with other treatments like chemotherapy and radiation. Understanding the risks and benefits is essential for patients considering this surgery as part of their cancer treatment journey.
On this Page
Subject Terms
Bilobectomy
ALSO KNOWN AS: Lobectomy, thoracotomy
DEFINITION: A bilobectomy is a surgical procedure to remove two contiguous lobes of the right lung.
Cancers treated: Various types of lung cancer
Why performed: A bilobectomy is performed to remove diseased lung tissue.
Patient preparation: Bilobectomy is performed under general anesthesia in a hospital with the usual preoperative preparation, such as physical examination, blood testing, and consultation with an anesthesiologist. In addition, an examination and additional lung tests will be done by a pulmonologist (a lung specialist).
Steps of the procedure: The surgical procedure is performed by a thoracic surgeon making a cut in the side; the rib cage is separated or cut away to allow the lungs to be seen, and the pleura (a membrane around the lungs) is also cut away. The lung being operated on may be deflated, and the other lung continues to work with the help of a breathing tube. The lobes of the lung are pulled apart and separated, and the diseased lobes are cut free and removed. Arteries and veins that have been cut are sealed or reconnected. A drainage tube is left in the chest wall to drain or suction out fluid and air. The procedure may take from two to five hours.
After the procedure: Pain medication will be used to make the patient more comfortable after the surgery. A hospital stay of about one week is to be expected; during hospitalization, breathing exercises as well as exercises for movement (range of motion) will be taught. Recovery at home can take several weeks, during which time pain medications may be used, the surgical site needs to be kept clean, and a gradual return to physical activity is recommended.
Risks: The risks of a bilobectomy procedure are a narrowing of the bronchi (the large air passages leading from the windpipe to the lungs), scar formation, injury to nerves during surgery that may cause numbness and tingling in the chest area, and leakage of air from the surgical site with partial or complete collapse of the lung. Venous thromboembolism, which are blot clots, are also a potential risk for patients. Though the risk for venous thromboembolism is between three and seven percent, the chances of death if the clots occur is high.
Results: Surgery, including bilobectomy, is most effective for Stage I and Stage II non-small-cell lung cancer. Smoking cessation is of utmost importance to maximize surgical treatment as it improves wound healing and allows for the best outcome when additional therapies, such as radiation and chemotherapy, are used.
Bibliography
Dong, Honghong, et al. “Postoperative Venous Thromboembolism after Surgery for Stage IA Non-Small-Cell Lung Cancer: A Single-Center, Prospective Cohort Study.” Thoracic Cancer 13.9 (2022): 1258-1266. doi:10.1111/1759-7714.14373. Accessed 3 July 2024.
Fossella, Frank V., J. B. Putnam, and Ritsuko Komaki. Lung Cancer. New York: Springer, 2003. Digital file.
Galetta, Domenico, et al. “Bilobectomy for Lung Cancer: Analysis of Indications, Postoperative Results, and Long-Term Outcomes (English).” Annals of Thoracic Surgery 93.1 (2012): 251–57. PASCAL. Web. 2 Oct. 2014.
Icard, Philippe, et al. “Does Bilobectomy Offer Satisfactory Long-Term Survival Outcome for Non-Small Cell Lung Cancer?” Annals of Thoracic Surgery 95.5 (2013): 1726–33. MEDLINE Complete. Web. 2 Oct. 2014.
Icard, Philippe, et al. “Morbidity, Mortality and Survival after 110 Consecutive Bilobectomies over Twelve Years.” Interactive Cardiovascular and Thoracic Surgery 16.2 (2013): 179–85. TOC Premier. Web. 2 Oct. 2014.
Ilonena, Ilkka K., et al. “Quality of Life Following Lobectomy or Bilobectomy for Non-Small Cell Lung Cancer, a Two-Year Prospective Follow-Up Study.” Lung Cancer 70.3 (2010): 347–51. Print.
Roth, Jack A. Lung Cancer. 4th ed. Hoboken: Wiley, 2014, Digital file.