17608 Lobectomy

Overview

A lobectomy is an operation to remove one lobe of an organ. The lungs have lobes: three on the right and two on the left. A lung lobectomy removes one of these lobes. The surgery is done to treat a problem in that lobe, such as cancer, a severe infection, or a lung abscess (a pocket of pus). It is not a disease itself.

Lung lobectomy is a common chest operation. It is a standard treatment for some lung cancers and for certain severe or long-lasting lung infections.

Lobectomy can be done in adults of any age. It is more common in older adults because lung cancer and long-term lung diseases are more common with age. It is rare in children.

Symptoms

Common symptoms

• A cough that does not go away
• Coughing up blood
• Shortness of breath or wheezing
• Chest pain
• Repeated chest infections
• Feeling very tired or losing weight without trying

Symptoms in children

• Lobectomy is rare in children. It may be needed for a birth defect in the lung or a severe infection that does not clear. Symptoms depend on the cause and can include breathing trouble, repeated chest infections, or poor feeding.

Symptoms in older adults

• Older adults may feel more tired and recover more slowly. They may also have other health conditions, such as heart or kidney problems, that need checking before surgery.

Causes

Main causes

• Lobectomy is a treatment, not a disease. Reasons it may be recommended include:
• Lung cancer
• A non-cancerous lung tumor
• Severe bronchiectasis (scarred and widened airways)
• A lung abscess (a pocket of infection)
• Severe tuberculosis
• A birth defect in the lung

Risk factors

• Smoking or exposure to secondhand smoke
• Family history of lung cancer
• Long-term lung diseases such as COPD
• Previous serious lung infections
• Exposure to asbestos or other harmful dusts

When to see a doctor

See a doctor urgently if:

• You have a new fever, chills, or a wound that looks infected after surgery
• You are coughing up blood
• You have sudden shortness of breath or chest pain
• You feel very weak or dizzy

Book a routine appointment if:

• A cough that lasts more than three weeks
• Coughing up blood even a small amount
• Unexplained weight loss
• Repeated chest infections
• Breathlessness that is new or getting worse

Diagnosis

The need for a lobectomy is found by checking your symptoms, doing a physical exam, and using imaging tests. A specialist will also check how well your lungs work. Sometimes a small tissue sample is needed to find the exact cause.

Tests that may be done

• Chest X-ray
• CT scan of the chest
• PET scan
• Bronchoscopy (a thin tube with a camera to look inside the airways)
• Biopsy (a small tissue sample)
• Lung function tests (breathing tests)
• Blood tests
• Sputum test (a test of mucus you cough up)

What to expect at your appointment

You may be referred to a chest specialist or surgeon. Before surgery, you will have a pre-op check to make sure your heart and lungs are strong enough. You will have time to ask questions and plan your recovery. Bring a family member or friend to appointments if that helps.

Treatment

A lobectomy is a major operation. It is done under general anaesthetic, which means you are asleep. The surgeon may make a cut in the chest or use keyhole surgery with small cuts. The aim is to remove the diseased lobe and leave healthy lung tissue to work. Other treatments may be used before or after surgery, depending on the reason for the operation.

Self-care at home

• Stop smoking before surgery if you can; ask your healthcare team for help
• Do the breathing exercises and gentle movement your team advises
• Keep the wound clean and dry
• Take pain relief as guided by your care team
• Eat well and drink enough fluids
• Go to your follow-up appointments

Medical treatments

Treatment depends on the reason for the lobectomy. For lung cancer, surgery may be combined with other treatments such as chemotherapy, radiation therapy, targeted therapy, or immunotherapy. For a severe infection, medicines to treat infection may be used before or after surgery. Your specialist team will explain the best plan for you. This article does not recommend any specific medicine.

When is surgery considered?

Surgery may be recommended when the problem is only in one lobe and other treatments are not enough or not suitable. Examples include some lung cancers, severe infections that do not clear, or a lung abscess. Your surgeon will explain the risks and benefits.

Living with this condition

Recovery takes time. You may feel tired for several weeks. Start with short walks and build up slowly. Do the breathing exercises your team gives you. Avoid heavy lifting until you are told it is safe. Plan for help at home for the first few weeks.

Lifestyle tips

• Stay away from cigarette smoke
• Avoid people with colds or flu when possible
• Keep active within your limits
• Get enough sleep
• Follow your follow-up plan

Diet and exercise

Eat a balanced diet with plenty of fruit, vegetables, and protein to help healing. Gentle exercise such as walking helps your lungs and strength. Ask about pulmonary rehabilitation, a supervised exercise and education programme for people with lung problems.

Mental health and emotional wellbeing

It is normal to feel anxious, scared, or low before or after surgery. You may worry about breathing or about cancer coming back. Talk to your team about how you feel. Support is available. If you have thoughts of harming yourself, contact your local crisis line or emergency services right away.

Prevention

You cannot prevent the need for a lobectomy directly. But you can lower the risk of some lung problems by not smoking, avoiding secondhand smoke, and getting recommended vaccines. If you have a lung condition, good care can sometimes stop it getting worse.

Vaccines

Ask your healthcare provider about recommended vaccines, such as flu and pneumonia vaccines, which can help prevent lung infections.

Screening programmes

In some countries, lung cancer screening is offered to people at high risk, such as people who have smoked for many years. Ask your doctor if you are eligible.

Complications

If left untreated

• The lung problem may get worse
• Cancer may spread to other parts of the body
• A severe infection may not clear or may spread
• Breathing may become more difficult
• You may feel more tired and less able to do daily activities

Long-term outlook

Many people recover well after a lobectomy. The remaining lung tissue can often do the work of the removed lobe. Recovery takes weeks to months. You will have follow-up to check your breathing and overall health. Most people can return to everyday activities, but some may feel more breathless with heavy exercise.

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