Name of the Procedure:

Primary Lung Carcinoma Resection
Common Names: Lung cancer surgery, Lung tumor removal
Technical/Medical Terms: Lobectomy, Pneumonectomy, Segmentectomy

Summary

Lung carcinoma resection surgery involves the removal of a primary lung tumor. This procedure is typically performed to treat non-small cell lung cancer, which includes types like squamous cell carcinoma and adenocarcinoma.

Purpose

The procedure is intended to remove cancerous tissue from the lungs to prevent the spread of cancer, improve lung function, and increase longevity. The primary goal is to achieve a margin-free tumor resection, meaning that no cancer cells are left at the edges of the tissue removed.

Indications

This procedure is indicated for patients diagnosed with primary lung carcinoma, particularly non-small cell lung cancer (NSCLC) varieties such as squamous cell carcinoma or adenocarcinoma, where the tumor is localized and has not metastasized extensively.

Preparation

• Fasting: Patients are usually required to fast for at least 8 hours before surgery.
• Medications: Adjustments to medication regimens may be necessary, particularly blood thinners.
• Diagnostic Tests: Pre-surgical assessments might include blood tests, imaging studies (CT scans, MRIs, PET scans), pulmonary function tests, and ECG.
• Consultations: Preoperative consultations with the surgical team, anesthesiologists, and possibly pulmonologists.

Procedure Description

1. Anesthesia: General anesthesia is administered to ensure the patient is unconscious and free of pain.
2. Incision: The surgeon makes an incision in the chest, the location and size depending on the tumor's size and position.
3. Resection: The affected lung section (lobe, segment, or entire lung) is carefully resected using specialized surgical tools. During this, lymph nodes may also be removed for further examination.
4. Closure: The incision is then closed with sutures or staples, and a chest drain may be placed to remove any fluids that accumulate.
5. Recovery: The patient is moved to a recovery area and monitored as they wake from anesthesia.

Duration

The procedure typically lasts between 2 to 5 hours, depending on the complexity and extent of the resection needed.

Setting

The surgery is performed in a hospital, specifically in an operating room equipped for thoracic procedures.

Personnel

• Surgeons: Typically a thoracic or cardiothoracic surgeon.
• Nurses: Operating room nurses and surgical technologists.
• Anesthesiologists: To manage anesthesia and monitor vital signs.

Risks and Complications

• Common Risks: Infection, bleeding, and reaction to anesthesia.
• Rare Risks: Persistent air leak, respiratory failure, and cardiovascular complications.
• Complications Management: Prompt intervention includes antibiotics for infections, drainage of air or fluids, and supportive respiratory care.

Benefits

Successful resection can lead to complete removal of the cancerous tissue, significantly improving survival rates and quality of life. Benefits are often noticeable within weeks to months, as lung function begins to stabilize.

Recovery

• Post-Procedure Care: Includes pain management, breathing exercises, and gradual mobilization.
• Recovery Time: Generally, 4 to 8 weeks. Intensive follow-up includes regular imaging and physical assessments.
• Restrictions: Avoiding strenuous activities for several weeks post-surgery. Adherence to follow-up appointments for monitoring recovery.

Alternatives

• Radiation Therapy: Less invasive but may not be as effective in removing localized tumors.
• Chemotherapy: Used either as a standalone treatment or in combination but typically not as a primary method for localized tumors.
• Targeted Therapy and Immunotherapy: Based on specific genetic markers of the tumor may be considered depending on individual patient factors.

Patient Experience

During the procedure, the patient will be under general anesthesia and will not feel any pain. Post-surgery, patients may experience discomfort at the incision site, shortness of breath, and general fatigue. Pain is managed through prescribed medications, and comfort measures include specialized pillows and breathing exercises to enhance recovery.