Surgery for lung cancer (LC) was once performed exclusively through thoracotomy. A long incision was made into the patient’s chest. Then, the ribs were either cut and removed, or spread apart to provide the surgeon with enough working space within the chest cavity. This was the approach taken for wedge resections (removal of a portion of the tissue) lobectomies (removal of a lobe), and pneumonectomies (removal of an entire lung).
Minimally invasive techniques that preclude spreading the ribs are being used with more regularity. There is less scarring involved because the incisions are smaller, and less postoperative pain because the procedure is less traumatic. Blood loss can usually be kept to a minimum, which means there is far less chance of excessive bleeding.
Below, we’ll explain what types of LC are addressed with a minimally invasive approach. You’ll also learn about the tests that are performed prior to the operation, and what to expect during your recovery.
Eligibility For Minimally Invasive Lung Cancer Surgery
A minimally invasive strategy is only used for early stage lung cancer. In Stage I, the cancerous cells are still confined to the lung. That allows the surgeon to perform video-assisted thoracic surgery (VATS) to remove a section of diseased tissue, a lobe, or the entire organ.
The approach is seldom taken for later stages of LC, even if the diseased cells are still confined within the chest (as in Stage II). Once the cancer spreads to other areas, a systemic approach must be taken. That typically requires chemotherapy, radiation treatment, and even use of alternative medications.
Tests That Are Performed Prior To Surgery
A number of preoperative tests can be performed to determine what stage the disease is in and the size of the tumors. These tests are usually done three or four weeks prior to treatment. It is during this time that the surgeon will decide whether minimally invasive lung cancer surgery is appropriate.
A physical examination is performed, and chest X-rays are taken. A CT (computed tomography) scan and a PET (positron emission tomography) scan are also done. Blood tests, an electrocardiogram, and a spirometry (for testing pulmonary function) are performed to provide more clarity with regard to staging the disease.
Once your surgeon has confirmed that you are a good candidate, a surgery date is selected.
Recovering After The Operation
The length of your recovery period will be dictated, in part, by the type of procedure you undergo. For example, if you are having a VATS lobectomy performed, you can expect to stay in the hospital for three to five days. A VATS pneumonectomy may require an extra two days. Once you leave the hospital, expect to spend up to six weeks (though as few as three) recovering before returning to your normal routine. You should wait an additional two to three weeks before resuming strenuous activities.
Your surgeon will want to schedule a follow-up appointment within a couple of weeks following the operation. At that time, the incisions will be examined and your initial recovery will be assessed.
If you suffer from early stage lung cancer, a minimally invasive surgical approach is usually the best option. As always, consult your doctor for guidance.