In lung cancer treatment, a lobectomy is a surgical procedure in which one of the five lobes of the lungs is removed. This intervention can be successful in treating the disease, especiallyearly-stage lung cancer. And as long as your remaining lobes are healthy, breathing shouldn’t be a problem after the procedure. However, a lobectomy is a major lung surgery. While it can be life-saving, it does come with a risk of complications that must be carefully considered.
Verywell / Hilary Allison
Before deciding to proceed with a lobectomy, your healthcare provider will review all your treatment options, your overall health, and the possibility of you experiencing short-term or long-term complications related to this procedure.
A lobectomy is the most common surgery used to treat early-stage non-small cell lung cancer.This is usually only an option for lung cancer atstage 1,stage 2, orstage 3A. It is also occasionally performed for other conditions, such astuberculosis, severeCOPD, or trauma that interrupts major blood vessels near the lungs.
Complete Guide to Lobectomy
Risk of Complications
Lobectomy has advantages over other surgical options for lung cancer. Among them: fewer serious complications.
For example, whereas a lobectomy removes one lobe of the lungs, a sleeve resection removes a lobe and some of the mainbronchus(airway). Apneumonectomyremoves the entire lung, rather than a lobe. The extent of these procedures alone makes them riskier than a lobectomy.
That is not to say that a lobectomy is not without the potential for complications. In fact, in some instances, more than half the people who undergo a lobectomy could suffer from some type of complication related to the procedure—ranging from something minor to a life-threatening issue.
The surgical technique matters, as risks are lower when the less invasive option—video-assisted thoracoscopic surgery (VATS)—is used.
VATSInvolves only a few small incisions in the chestTumor removed with minimal disruption to the chest areaComplications may occur in between 6% and 34% of casesOpen Lobectomy or ThoracotomyA large incision is made across the chestThe ribs are spread apart so the surgeon can access the lungs and remove the tumorComplications may be as high as 58% for an open lobectomy
VATSInvolves only a few small incisions in the chestTumor removed with minimal disruption to the chest areaComplications may occur in between 6% and 34% of cases*
Involves only a few small incisions in the chest
Tumor removed with minimal disruption to the chest area
Complications may occur in between 6% and 34% of cases*
Open Lobectomy or ThoracotomyA large incision is made across the chestThe ribs are spread apart so the surgeon can access the lungs and remove the tumorComplications may be as high as 58% for an open lobectomy*
A large incision is made across the chest
The ribs are spread apart so the surgeon can access the lungs and remove the tumor
Complications may be as high as 58% for an open lobectomy*
*Estimates of the potential risks related to lobectomies vary widely. Data based on a review of major studies on the different techniques.
However, VATS procedures are not always possible or preferable to an open-chest procedure. Depending on where the tumor is located, it may not be accessible for removal via video-assisted surgery.
Also, your surgeon may determine that an openthoracotomyprovides a better chance of ensuring that all the cancerous tissue is removed.
Understanding the Risks of Surgery
Types of Complications
Advances in VATS and traditional open-chest surgery have helped to improve the outcomes of lobectomy. If you are having this procedure, you should be prepared for possible problems that can occur.
Most complications of surgery begin to show signs in the days right after your operation, but some may persist or develop later on.
Cardiac Arrhythmia
Atrial arrhythmia is an irregular heartbeat that begins in the upper chambers of the heart.
Cardiac arrhythmias are common in patients who undergo general anesthesia and this one of the most common complications related to a lobectomy. The condition can result in aheart attackorstroke.
Persistent Air Leak
After surgery, an air leak can form. This problem is usually transient and self-limited and occurs in approximately 50% of people who have part of their lung tissue removed.
Usually, the problem will resolve on its own within a few hours or days. In other circumstances, it requires a post-operativechest tubeto be left in place longer than planned.
Lung Collapse
When a lung collapses (known asatelectasis), the air sacs won’t fill with air, so the lung cannot function. This is an uncommon, but serious, risk after surgery. It’s often the result of prolonged use of a ventilator and the inability to cough (and, therefore, naturally clear the lungs) while under anesthesia.
Pneumonia
Atelectasis can progress into more serious conditions, includingpneumonia. This infection can be minor or lead to a life-threatening situation. Studies show that the risk for pneumonia after thoracic (chest) surgery is about 6%.
Ventilator Dependence
A need to be on a respirator for a prolonged period of time after surgery is a concern for people having lung cancer surgery. Prolonged ventilation may be required if you’re dealing with another complication from your lobectomy, such as apost-operative infection.
Excessive Bleeding
Hemorrhaging, or excessive bleeding, after a lobectomy seems to occur in almost 3% of cases. If this happens to you, you may need to go back into surgery for control of bleeding.
Bronchopleural Fistula
A rare, but potentially fatal complication,bronchopleural fistulais an abnormal passageway that develops between large airways of the lungs and the spaces between the membranes that line the lungs. You will be taken back into the operating room to correct the problem if it occurs.
Blood Clots
Deep vein thrombosis (DVTs), blood clots in the legs, may travel to the lungs. This is known aspulmonary embolusand is one of the most serious potential complications of thoracic surgery.
Your healthcare provider will take precautions to avoid this problem, and you should follow any advice you are given to reduce your risk, which may include takinganticoagulant medicationsor following a specific schedule for walking and resting.
What Are Blood Clots?
Post-Operative Pain
VATS procedures are associated with lower levels of pain. In fact, studies have found that the recovery period following a VATS lobectomy is often shorter, with less post-operative pain than an open lobectomy.
Chronic Pain
One of the most difficult long-term issues that you may have to deal with is postpneumonectomy syndrome, or thoracotomy pain syndrome.
Between 50% and 70% of people who undergo the removal of lung tissue feel pain for two or more months after surgery; more than 40% still have some degree of pain at the one year mark after surgery; and, in all, 5% experience significant levels of pain.
Chronic Pain Syndromes After Lung Cancer Surgery
Death
All surgeries also carry a risk of fatality. Thankfully, both forms of lobectomy surgery have low mortality rates.
It’s estimated that surgery-related problems could cause fatal complications in 1% to 3% of those who have had either an open thoracotomy or VATS. In these instances, pneumonia and respiratory failure are the most common causes of death.
Lobectomy Prognosis
The prognosis following a lobectomy depends on many factors. These include which lobe is removed and the stage of the lung cancer. Other factors that may influence the outcome of surgery are age,smoking history,chronic obstructive pulmonary disease (COPD)status, and whether or not you are obese.
Lobectomy can improve survival, and sometimes this treatment is combined withradiation therapy.
When a lobectomy is successfully done for early-stage lung cancer, it offers a chance for long-term survival withoutrecurrenceof cancer. A lobectomy for non-small cell lung cancer may even result in a cure.
Important Facts About Lung Cancer Survival Rates
A Word From Verywell
While it’s good to be aware of the possibility of complications from a lobectomy, it’s important to realize that every person is different. Your risk may actually be much lower than average if your general health is good.
Discuss your specific risks with your healthcare provider (e.g., lifestyle, family history, chronic conditions), and see if there are things you can do before the surgery to help you reduce the odds of complications, such as losing weight or quitting smoking. It’s also a good idea to seek asecond opinionto ensure that no details are overlooked when it comes to planning your treatment.
11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
National Cancer Institute.Non-small cell lung cancer treatment: health professional version.
Dziedzic D, Orlowski T.The Role of VATS in Lung Cancer Surgery: Current Status and Prospects for Development.Minim Invasive Surg. 2015;2015:938430. doi:10.1155%2F2015%2F938430
Lackey A, Donington JS.Surgical management of lung cancer.Semin Intervent Radiol. 2013;30(2):133–140. doi:10.1055/s-0033-1342954
Mueller MR, Marzluf BA.The anticipation and management of air leaks and residual spaces post lung resection.J Thorac Dis. 2014;6(3):271-284. doi:10.3978/j.issn.2072-1439.2013.11.29
Miskovic A, Lumb AB.Postoperative pulmonary complications. Br J Anaesth. 2017;118(3):317-334. doi:10.1093/bja/aex002
Ziarnik E, Grogan EL.Postlobectomy Early Complications.Thorac Surg Clin. 2015;25(3):355–364. doi:10.1016/j.thorsurg.2015.04.003
Wang Z, Pei C, Ma L, et al.Acute pulmonary embolism after pneumonectomy.J Thorac Dis. 2012;4(1):76-82.doi:10.3978%2Fj.issn.2072-1439.2011.10.02
Bruce J, Quinlan J.Chronic Post Surgical Pain.Rev Pain. 2011;5(3):23–29. doi:10.1177/204946371100500306
Bryant A, Mundt R, Sandhu A, et al.Stereotactic Body Radiation Therapy Versus Surgery for Early Lung Cancer Among US Veterans.Ann Thorac Surg. 2018;105(2):425-431. doi:10.1016/j.athoracsur.2017.07.048
American Cancer Society.Surgery for Non-Small Cell Lung Cancer.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
