Lobectomy (lung)
Updates to Article Attributes
A lobectomy (plural: lobectomies) is the complete resection of one lobe of the lung and is the commonest lung surgery performed for bronchogenic carcinoma.
Technique
A posterolateral thoracotomy is the commonest approach for the resection of lung malignancies.
For other surgical approaches for lobectomy see the main article on lung surgery.
A standard lobectomy involves complete resection of a whole lobe of the lung and also necessitateswith concurrent removal of the associated pulmonary vasculature, bronchi, visceral pleura and mediastinal nodal dissection
Indications
A multilobar resection is a bilobectomy or lobectomy plus sublobar resection, and may be necessary when more than one lobe is involved, usually due to pleural invasion or an incomplete lobar fissure 1.
Contraindications
A sleeve lobectomy, which is a lobectomy coupled with a partial resection of a bronchus, is usually performed when there is malignant involvement of the main bronchus/lobar bronchial lumen. The remaining native bronchi are anastomosed 1.
Postoperative complications
Early complications are those that occur within the first postoperative month, whilst late refers to those that happen once a month has elapsed 3.
Early
- atelectasis: commonest complication
- postoperative pulmonary oedema
- pneumonia (rarely empyema)
- ARDS
- bronchial dehiscence
- bronchopleural fistula (BPF)
- lung torsion
- pulmonary vein stump thrombosis: rare after lobectomy
- anastomotic dehiscence: more common with sleeve lobectomy
- pulmonary embolism (PE)
- haemothorax
- chylothorax
- acute mediastinitis
Late
History and etymology
The original development of lobectomy was for the treatment of tuberculosis, specifically a partial lobectomy in 1893 by the British surgeon David Lowson (1850-1907) 4.
-<p>A <strong>lobectomy</strong> (plural: lobectomies) is the complete resection of one lobe of the <a title="Lung" href="/articles/lung">lung</a> and is the commonest <a title="Lung surgery" href="/articles/lung-surgery">lung surgery</a> performed for <a title="Bronchogenic carcinoma" href="/articles/lung-cancer-3">bronchogenic carcinoma</a>.</p><h4>Technique</h4><p>A posterolateral thoracotomy is the commonest approach for the resection of lung malignancies.</p><p>For other surgical approaches for lobectomy see the main article on <a title="Lung surgery" href="/articles/lung-surgery">lung surgery</a>. </p><p> </p><p>complete resection of a whole lobe of the lung and also necessitates removal of the associated pulmonary vasculature, bronchi, visceral pleura and mediastinal nodal dissection</p><h4>Indications</h4><p> </p><h4>Contraindications</h4><p> </p><h4>Postoperative complications </h4><p> </p><h4>History and etymology</h4><p> </p>- +<p>A <strong>lobectomy</strong> (plural: lobectomies) is the complete resection of one lobe of the <a href="/articles/lung">lung</a> and is the commonest <a href="/articles/lung-surgery">lung surgery</a> performed for <a href="/articles/lung-cancer-3">bronchogenic carcinoma</a>.</p><h4>Technique</h4><p>A posterolateral thoracotomy is the commonest approach for the resection of lung malignancies. For other surgical approaches for lobectomy see the main article on <a href="/articles/lung-surgery">lung surgery</a>. </p><p>A standard lobectomy involves complete resection of a whole lobe of the lung with concurrent removal of the associated pulmonary vasculature, bronchi, visceral pleura and mediastinal nodal dissection</p><p>A <strong>multilobar resection</strong> is a bilobectomy or lobectomy plus sublobar resection, and may be necessary when more than one lobe is involved, usually due to pleural invasion or an incomplete lobar fissure <sup>1</sup>.</p><p>A <strong>sleeve lobectomy</strong>, which is a lobectomy coupled with a partial resection of a bronchus, is usually performed when there is malignant involvement of the main bronchus/lobar bronchial lumen. The remaining native bronchi are anastomosed <sup>1</sup>.</p><h4>Postoperative complications </h4><p>Early complications are those that occur within the first postoperative month, whilst late refers to those that happen once a month has elapsed <sup>3</sup>.</p><h5>Early</h5><ul>
- +<li>
- +<a href="/articles/lung-atelectasis">atelectasis</a>: commonest complication</li>
- +<li>postoperative pulmonary oedema</li>
- +<li>
- +<a href="/articles/pneumonia">pneumonia</a> (rarely <a href="/articles/empyema-1">empyema</a>)</li>
- +<li><a href="/articles/acute-respiratory-distress-syndrome-1">ARDS</a></li>
- +<li><a href="/articles/bronchial-dehiscence">bronchial dehiscence</a></li>
- +<li><a href="/articles/bronchopleural-fistula-2">bronchopleural fistula (BPF)</a></li>
- +<li><a href="/articles/lung-torsion">lung torsion</a></li>
- +<li>
- +<a href="/articles/pulmonary-vein-stump-thrombosis">pulmonary vein stump thrombosis</a>: rare after lobectomy</li>
- +<li>anastomotic dehiscence: more common with sleeve lobectomy </li>
- +<li><a href="/articles/pulmonary-embolism">pulmonary embolism (PE)</a></li>
- +<li><a href="/articles/haemothorax">haemothorax</a></li>
- +<li><a href="/articles/chylothorax">chylothorax</a></li>
- +<li><a href="/articles/acute-mediastinitis">acute mediastinitis</a></li>
- +</ul><h5>Late</h5><ul><li> </li></ul><h4>History and etymology</h4><p>The original development of lobectomy was for the treatment of <a href="/articles/tuberculosis-pulmonary-manifestations-1">tuberculosis</a>, specifically a partial lobectomy in 1893 by the British surgeon <strong>David Lowson</strong> (1850-1907) <sup>4</sup>.</p>
References changed:
- 1. de Groot P, Truong M, Godoy M. Postoperative Imaging and Complications in Resection of Lung Cancer. Semin Ultrasound CT MR. 2018;39(3):289-96. <a href="https://doi.org/10.1053/j.sult.2018.02.008">doi:10.1053/j.sult.2018.02.008</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/29807639">Pubmed</a>
- 2. Rotman J, Plodkowski A, Hayes S et al. Postoperative Complications After Thoracic Surgery for Lung Cancer. Clin Imaging. 2015;39(5):735-49. <a href="https://doi.org/10.1016/j.clinimag.2015.05.013">doi:10.1016/j.clinimag.2015.05.013</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/26117564">Pubmed</a>
- 3. Kang Y, Kim J, Cha Y, Jeong Y. Imaging Findings of Complications After Thoracic Surgery. Jpn J Radiol. 2019;37(3):209-19. <a href="https://doi.org/10.1007/s11604-018-00806-y">doi:10.1007/s11604-018-00806-y</a> - <a href="https://www.ncbi.nlm.nih.gov/pubmed/30637569">Pubmed</a>
- 4. Anton Sebastian. A Dictionary of the History of Medicine. (1999) ISBN: 9781850700210 - <a href="http://books.google.com/books?vid=ISBN9781850700210">Google Books</a>
Tags changed:
- cases
Sections changed:
- Approach
Systems changed:
- Chest
- Oncology