If a mesothelioma patient must have a tumorous or unhealthy lung removed, then a procedure called a pneumonectomy will be performed. The goal of this procedure is to completely prevent the dangerous spread of malignant cells to any other sites in a patient’s body.
When doctors are deciding if a patient should undergo a pneumonectomy, rather than performing a lesser method of lung resection, a few determining factors are considered. These include the size and location of the tumors in the lungs and the degree of invasion of mediastinal lymph nodes within the chest cavity. The most common histologic form of cancer suitable for this type of procedure is squamous cell carcinoma, which shows a 69 percent success rate.
There are less-aggressive resection surgeries performed by doctors that present a much lower morbidity rate than a pneumonectomy. Surgeons must therefore determine the optimum benefits versus the operative risks when deciding to perform a pneumonectomy. Candidates must be in overall good health, exhibit durable heart function, and must not have any other area of the body metastasized with cancer. This aggressive surgery method leads to a 20 percent loss in exercise capacity and a permanent loss of about 33 percent of pulmonary function. Candidates who are selected for this surgery must have a solid prognosis for recovery and quality of life post-operation.
Procedure and Recovery for a Pneumonectomy
At the start of a pneumonectomy procedure, a thoracotomy will be performed. Under general anesthesia, a long incision will be made in the chest area and, many times, part or all of a rib will be removed to assist in facilitating surgery. The affected lung will then be collapsed and removed through the incision. Surgeons will carefully inspect all vessels and incisions in order to ensure that nothing is leaking, and a temporary draining tube will be inserted to remove fluid, air, and blood from the surgical cavity before the chest incision is closed. These drainage tubes will remain intact for several days to remove any excess fluid buildup, and patients will also require breathing assistance through a respirator. There also is the possibility of receiving medications and nutrition intravenously.
Benefits and Risks of a Pneumonectomy
The success of pneumonectomy surgery and a patient’s overall prognosis will depend on many factors, including a patient’s overall general health before the surgery, gender, age, the type and stage of the cancer, and also which lung was removed. Gradually, the remaining lung must take over and help a patient breathe as if both lungs were still intact. However, 60 percent of patients still suffer with shortness of breath for up to six months after surgery as a result. As with any surgery, risks include unfavorable reactions to medications, infection, and bleeding. Even though there are risks with this type of mesothelioma surgery, it can greatly improve the quality of life of suffering patients by easing the chronic and extremely painful symptoms of the disease. This surgery also prolongs a patient’s life over 90 percent of the time.