Lobectomy is a type of treatment for lung cancer in which an entire lobe of lung tissue is surgically removed. When two lobes are removed, the procedure is called bilobectomy.
The lungs have five lobes — three in the right lung and two in the left lung, near the heart. Lobectomy is the most common type of surgery for lung cancer and is performed when the cancer affects only part of the lung. When the entire lung is removed, the procedure is called a pneumonectomy.
Lobectomy is performed in two ways: thoracotomy and video-assisted thoracic surgery (VATS). During a thoracotomy, an incision is made between the ribs, and the chest wall is opened for surgery on the lung.
VATS is a less invasive procedure that can be performed in cases of early-stage lung cancer. It involves making several small incisions in the chest. These incisions allow a video camera to guide small instruments to extract a lobe without opening the ribs. Shorter hospital stays, faster recovery, and less pain are associated with VATS lobectomy.
If lobectomy is appropriate for your lung cancer, you can prepare for the procedure in ways that may aid your recovery and help prevent complications.
Facing lung surgery can be stressful, and emotional and physical issues may arise. Understanding the procedure can help you cope with any concerns.
One MyLungCancerTeam member described their situation in response to another member undergoing surgery: “I’m having a lobectomy. Looks like stage 1. Like you, I just want it out, and surgery is the best way to do that from all my research. Am I afraid? Yeah, it’s a big deal. But I’m much more concerned if I don’t have surgery.”
If you, your oncologist, and your cardiothoracic surgeon determine that you are a good candidate for a lobectomy, be sure you understand important steps you need to take before surgery. Follow your doctor’s recommendations carefully.
Typically, people undergoing lobectomy are advised to do the following:
You will have a number of tests before your surgery that may require several appointments. Your doctors need to ensure that your health is suitable for a lobectomy. Tests may include:
Your surgeon needs to know about other conditions that may affect your surgery. If you have sleep apnea and use a breathing device, you may need to bring your device with you to the hospital. Men who are over 50 or have a history of enlarged prostate may be given a drug to prevent problems with urination after surgery.
You will also be evaluated for conditions that are risk factors for complications with lobectomy, such as high blood pressure and other types of cardiovascular disease, diabetes, and preoperative radiation or chemotherapy.
Your doctor may advise exercises for physical and mental conditioning before having a lobectomy. Studies show that deep breathing and other types of physical conditioning can increase lung function, physical health, and emotional well-being and may help prevent complications after surgery.
Be sure you work with your doctors to ensure that you are doing exercises that are appropriate for your condition, and follow any recommendations from your doctor. Talk to your doctor about referrals for physical therapy if you need assistance with a recommended preoperative exercise program.
Research has shown that outcomes improve when people with lung cancer and their caregivers are well-informed about the upcoming surgery and its aftermath. In a study with 60 participants who were either undergoing lung surgery or caring for someone who was, emotional quality of life was significantly better when people became knowledgeable about the procedures. The participants’ symptoms also showed improvement after surgery compared with the control group, who did not receive a plan for lung surgery preparation.
It’s important to have a clear understanding of what will happen before surgery, the day of surgery, and during recovery in the hospital, as well as what to expect while healing at home. Take time to talk with your doctors about each step of the surgical process. Your health care providers may offer an educational program or other resources to help you better understand what you will be going through.
Many MyLungCancerTeam members have questions about recovering from lobectomy.
“Just had a lobectomy three weeks ago. Anyone know how long it generally takes for the pain to go away or subside? Feels like I have a heavy weight on the left side of my chest and on my left side, plus a lot of tenderness still,” one member wrote.
Experiences with lobectomy can vary. Another member wrote, “Had a lobectomy. Walked out of the hospital under my own power 50 hours later with no pain meds. Have to take it easy.”
During your lobectomy, at least one chest tube will be inserted in your lung to remove air and drain fluid while you are in the hospital. On average, a chest tube is removed after about two days. In rare cases, a chest tube may need to remain when you return home. If that happens, your doctor will tell you how to manage the tube.
While in the hospital, you will learn breathing and coughing exercises to improve your lung function. Some people require oxygen both in the hospital and at home. You will also be guided on movement and walking protocols, often within hours after surgery, to help strengthen your lung capacity and support healing. You may have a chest X-ray shortly after surgery.
The length of a hospital stay after a lobectomy can vary. The average hospital stay with a thoracotomy is six to seven days, whereas a less invasive VATS lobectomy requires an average stay of four or five days. After you are discharged, it’s essential to follow your doctor’s recommendations for pain medication, exercise, and activities. You will also be scheduled for a follow-up evaluation.
In some cases, your doctor may recommend radiation or chemotherapy after a lobectomy.
Managing your recovery at home requires time and patience. It can take weeks or months to feel normal. After a lobectomy, it is common to experience some pain, fatigue, shortness of breath, or a dry cough. You will be given pain medication and instructions for transitioning away from narcotic painkillers to avoid dependence or side effects such as constipation. Contact your doctor immediately if you develop a fever or any other signs of infection.
Arrange for help with chores, errands, cooking, and other daily tasks from a family member, friend, or caregiver. You will likely need help for a few weeks while you recover.
Your doctor will provide information about how to keep your incision clean, how to manage fatigue and pain, and when to do breathing exercises. Be sure to follow your doctor’s recommendations for walking and maintaining appropriate amounts of activity.
Physical therapy is often prescribed to aid recovery. Exercises can help clear bronchial fluids, expand the chest, improve posture, increase range of motion in the shoulder, and promote general conditioning. Each of these aspects is important for healing respiratory muscles and regaining strength.
Many people who have surgery for lung cancer experience depression and anxiety afterward. Postoperative symptoms can worsen psychological distress. Talk with your health care team if you need help addressing mental health issues related to your lobectomy. Your doctors can provide referrals for mental health evaluation and treatment.
Learn more about how lung cancer can affect your mental health.
Complications may arise after a lobectomy. The most common problem is a prolonged air leak in the lung, which occurs in 15 percent to 18 percent of pulmonary resections. The risk is higher among people with emphysema.
Other less common complications include:
Contact your health care providers if you feel any unusual symptoms, such acute chest pain.
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