Surgical Procedures: Lobectomy

What is a lobectomy and how is it done?

A lobectomy is when part of your lung is removed. The lungs are two large organs in each side of your chest cavity. Each lung is made up of lobes or sections. The left lung has two lobes. The right has three lobes and is larger.

Your lungs help filter oxygen and move it into our blood. The lungs also keep us safe us from harmful things like smoke, pollution, bacteria, and viruses by trapping them in mucus that is made by the lungs. This mucus is then removed from the body by coughing and/or swallowing.

A lobectomy may be used to treat some cases of:

• Lung cancer.
• Tuberculosis (TB).
• Lung abscess (a pocket of inflammation in the lung caused by an infection).
• Fungal infection.
• Emphysema (the air sacs in the lungs don’t work as they should).
• Non-cancerous tumor.

There are two ways to do a lobectomy:

• Thoracotomy: An incision (cut) is made between two ribs, from the front of the chest to the back. The lobe is removed through this incision.
• Video-Assisted Thoracic Surgery (VATS): Small incisions are made, where your surgeon will place a thoracoscope (tube with a camera). The surgeon can see inside your chest. VATS is less invasive than having a thoracotomy.

What are the risks of a lobectomy?

There are risks and side effects to having a lobectomy. Risks and side effects may be:

• Reaction to anesthesia (medication you are given to help you sleep through the surgery, to not remember it, and to help with pain). Reactions can include wheezing, rash, swelling, and low blood pressure.
• Bleeding.
• Infection.
• Damage to nearby organs like the heart, lungs, blood vessels, and nerves.
• An air leak in the lung leading to a pneumothorax (lung collapse).
• Empyema (collection of pus).
• Long-term, chronic pain.
• Bronchopleural fistula (abnormal connection of the bronchus and pleural space), which can lead to fluid in the chest.
• Air or gas in the chest.

What is recovery like?

Recovery from a lobectomy depends on the type of surgery you have had. A 5-10 day stay in the hospital may be needed. Often, a temporary chest tube(s) may be placed to remove extra fluid and/or air.

You will be told how to care for your incisions and drains and will be given any other instructions before leaving the hospital. You may need supplemental oxygen at home and will be taught how to do so.

Your medical team will talk with you about the medications you will be taking for pain, blood clot, infection, and constipation prevention, and/or other conditions.

Your provider will talk with you about any changes in activity you may need to make. In general:

• Take medications as prescribed. Talk with your healthcare team before taking medications that may raise your risk of bleeding, including aspirin.
• Keep your incisions clean and dry. Care for your incision as you were taught.
• Talk with your healthcare team about showering/bathing. Often, you will be told to avoid rubbing the stitches when washing. Instead, pat the incision dry with a clean towel.
• Do breathing exercises as you were taught.
• Try not to do any heavy lifting until your healthcare team tells you it is safe to do so. Your provider will tell you how much weight you can lift.
• Stay away from people with colds, the flu, or other respiratory (lung) infections. Avoid chemical fumes, and/or environmental pollution.
• Avoid smoking and second-hand smoke. If you would like help quitting, speak to your provider.
• Use supplemental oxygen as directed.

What will I need at home?

• Thermometer to check for fever, which can be a sign of infection.
• Wound care, drain, and/or oxygen supplies, supplied to you either by the hospital, your surgeon’s office, or a homecare company.

When to call your healthcare team:

• If you have a fever. Your care team will tell you at what temperature they should be called.
• Chills or any other signs of infection.
• Pain, redness, swelling, drainage, or bleeding at your incision.
• Shortness of breath, coughing with or without green, yellow, or bloody mucous, having a hard time breathing, or pain with breathing.
• Chest pain (new or worsening).
• Nausea and/or vomiting.

Seek medical attention RIGHT AWAY if:

• You are coughing up blood (more than a teaspoon) or you have a lot of brown/bloody sputum.
• You have dizziness, are fainting, or if you pass out.
• You feel an irregular heartbeat.
• Your surgical bandage is soaked with blood or if your incision has come apart (separated), is swollen, red, or leaking pus.
• You have chest pain.
• There is swelling, redness, warmth, tenderness, and/or pain in the leg or calf.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is okay to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection, and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.