32442 Removal of lung, pneumonectomy; with resection of segment of trachea followed by broncho-tracheal anastomosis (sleeve pneumonectomy)

Name of the Procedure:

Removal of Lung, Pneumonectomy; with Resection of Segment of Trachea followed by Broncho-Tracheal Anastomosis (Sleeve Pneumonectomy).

Summary

A sleeve pneumonectomy is a surgical procedure where a lung is removed along with a portion of the trachea. The remaining bronchus is then attached to the trachea to maintain airway continuity.

Purpose

This procedure is primarily performed to treat lung cancer or other serious conditions affecting the lung and trachea. The goal is to remove malignant or diseased tissue while preserving as much healthy tissue as possible to maintain respiratory function.

Indications

• Non-small cell lung cancer involving the main bronchus and trachea
• Recurrent or persistent malignant tumors
• Severe lung damage from infection or trauma
• Conditions where less invasive treatments are insufficient

Preparation

• Patients may need to fast for several hours before surgery.
• Medication adjustments, including blood thinners, may be required.
• Pre-operative assessments: chest X-rays, CT scans, pulmonary function tests, blood tests, and possibly a bronchoscopy.

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made in the chest to access the lung and trachea.
3. The affected lung and a segment of the trachea are carefully removed.
4. The remaining bronchus is then connected to the trachea through an anastomosis (surgical connection).
5. The integrity of the reconnected airway is checked, and surgical drains are placed.
6. The incision is closed, and the patient is taken to recovery.

Duration

The procedure typically takes between 4 to 6 hours, depending on the complexity and patient-specific factors.

Setting

The procedure is performed in a hospital's surgical suite.

Personnel

• Thoracic surgeon
• Anesthesiologist
• Surgical nurses
• Respiratory therapists
• Operating room technicians

Risks and Complications

• Common: Infection, bleeding, anesthesia-related complications.
• Rare: Airway leakage, bronchial stenosis, respiratory failure, heart complications.
• Management: Close monitoring, antibiotics, additional surgeries if needed.

Benefits

• Removal of diseased or cancerous tissue
• Potential for prolonged survival and improved quality of life
• Immediate improvement in symptoms post-recovery

Recovery

• Initial recovery in the ICU for close monitoring.
• Pain management with medications.
• Gradual increase in physical activity.
• Follow-up appointments to monitor healing and lung function.
• Typical recovery time is several weeks to months.

Alternatives

• Lobectomy (removal of a lobe of the lung)
• Radiation therapy
• Chemotherapy
• Advantages of alternatives: Less invasive, shorter recovery times.
• Disadvantages: May be less effective in completely removing diseased tissue.

Patient Experience

• Post-operative pain managed with medications.
• May experience shortness of breath and fatigue initially.
• Gradual improvement in breathing and overall strength.
• Importance of adhering to follow-up care and pulmonary rehabilitation for optimal recovery.