Surgery of the lungs is performed to treat lung masses, collapsed lung or fluid around the lungs. There are two methods to do this.
One, Video-Assisted Thoracic Surgery (VATS) uses several very small incisions (each about 1cm or less). The surgeon places a small tube containing a camera through one of the incisions and can view the lungs on video monitor. This procedure is less invasive than traditional lung surgery that requires a thoracotomy incision.
Two, Thoracotomy uses a larger incision in the chest wall. This opening allows the surgeon to see the lungs directly.
In our Thoracic Surgery unit at the National University Heart Centre, Singapore (NUHCS), greater than 95% of our patients are treated with VATS without the need for thoracotomy.
Why do you need this surgery?
A Lung Mass
Disruption of cell growth in the lungs results in the formation of a mass, also known as a tumor. If a mass has been found in the lungs, surgery will help to determine its cause. If necessary, the mass may also be removed.
A Collapsed Lung
If a portion of the lung wall is thin or ruptured, air may leak into the pleural cavity. The pleural cavity is the space between the chest wall and the lungs. When air collects in the pleural space, the lung may collapse. This condition is known as a collapsed lung or pneumothorax.
Fluid Around the Lungs
Fluid may collect in the area around the lungs. One common cause of this fluid is lung infection, which may occur following certain types of surgeries or illnesses such as pneumonia.
What to expect?
For Lung Mass
A biopsy will be performed to remove a small amount of tissue from your lungs to allow your surgeon to determine whether the growth is benign (non cancerous) or malignant (cancerous).
In addition, the exact location and size of the mass can be measured, and other areas can be examined to check whether the mass has spread. If the mass needs to be removed, its size, location, and spread determine how much of the surrounding lung also needs to be removed
For Collapsed Lung
Tubes placed during surgery can drain air from the pleural space to help the lung re-expands. During surgery, a procedure is performed to help the lung stick to the chest wall. The surface of the lung can also be repaired so that it won't collapse again.
For Fluid Around the Lungs
During surgery, tubes can be placed into the pleural space to drain the fluid out and help the lungs to heal.
How should you prepare for the surgery?
Our surgeons will provide you with instructions on how to get ready for the procedure and explain what the surgery can do to help your condition
Stop smoking if you are currently a smoker
Have blood tests of other routine tests that your doctor recommends- Tell your doctor about any medications you are taking and ask if you should stop taking them
On the night before your surgery, do not eat or drink anything after midnight
What are the potential risks or complications?
There are always some risks when you have general anaesthesia. Discuss these risks with your doctor
There is a risk of bleeding from this operation
You may experience some pain or numbness at the incision site
There are risks of infection of the lungs or air leak through the lung wall- Blockages may develop in a blood vessel of the leg with potential for blood clots in the lung
What happens after the surgery?
It is possible that you will stay one night in the high dependency unit or ICU before being transferred to a regular ward. Your condition will be monitored by carefully recording your heartbeat and the amount of oxygen in your system
There may be one or two small flexible tubes from your chest to drain air and fluid out. These tubes are usually removed several days after the operation
You will be given pain medicines to keep you comfortable
You will be taught breathing exercises to improve the healing of your body. Doing deep breathing and coughing exercises after lung surgery is very important to help you recover.
You doctor will review the results of your surgery, tell you what to expect during your recovery, and discuss any further treatments that you may need for your condition
Have a relative or friend to pick you up on the day of your discharge
Follow the advice given to you by your doctor regarding wound care and when to call your doctor
Avoid strenuous activities for the first 1-2 weeks, also avoid lifting heavy objects
You may do light exercises that do not cause pain or pulling across your chest
When should you call the doctor?
Call your doctor if you have any of these symptoms:
Wound discharge or very red incision
Sudden, severe shortness of breath
Sudden, sharp chest pain
Fever over 38 degree Centigrade- Rapid heartbeat or "fluttering" in your chest
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