What is a pneumonectomy?

A pneumonectomy is a surgical procedure that removes an entire lung. It is performed for the treatment of lung cancer. To have this surgery, your other lung must be healthy enough to continue to provide the oxygen your body needs.

There are two types of pneumonectomy procedures:

  • Standard pneumonectomy: Also called simple pneumonectomy, this is the most commonly performed type of pneumonectomy. Your surgeon removes only the lung.
  • Extrapleural pneumonectomy: Extrapleural pneumonectomy is a more extensive surgery. It removes the lung and parts of the diaphragm, lining around the heart and the lungs.
Healthcare provider attentively listens to the chest of a male patient before a pneumonectomy procedure.

How is a pneumonectomy performed?

Thoracotomy

Traditional open surgery is the most common way to perform a pneumonectomy. Rarely, you may have minimally invasive options for earlier-stage cancers. Your care team will work with you to decide the right pneumonectomy surgery for you.

 

Video-assisted thoracic surgery (VATS)

Video-assisted thoracic surgery (VATS) is a minimally invasive type of thoracic surgery. It uses multiple small incisions to insert a camera and tools used by your surgeon to perform surgery. This approach is occasionally used for pneumonectomy, but it is rare.

Robot-assisted surgery

Robot-assisted surgery is a minimally invasive surgery that uses multiple small incisions and robotic arms your surgeon guides at a console. Your surgeon can use it to perform a pneumonectomy.

 

Why is a pneumonectomy performed?

Pneumonectomy is a major surgery, so it’s only recommended when other less extensive surgeries are no longer an option. For example, you might need this surgery if you have lung cancer that has grown too much or is located in a hard-to-reach area in the middle of your chest.

Some of the reasons you might need a pneumonectomy include:

  • Cancer in the chest, including lung cancer, mesothelioma or cancer that has spread from another area of the body
  • Chronic obstructive pulmonary disease, known as COPD
  • Fungal and bacterial infections in the lung, including tuberculosis
  • Lung injuries
  • Bronchiectasis, where your airways are damaged and widen

Preparing for a pneumonectomy

You'll go through several steps to get ready for a pneumonectomy. Your care team will order additional tests to ensure the procedure is right for you and check your overall health. If you have cancer, these tests may also help with lung cancer staging to make sure that the cancer has not spread to other areas of the body.

The tests you'll need before a pneumonectomy could include:

  • Blood tests
  • Imaging tests, including chest X-ray, CT scan or PET scan
  • Pulmonary function test
  • Echocardiogram to check on your heart
  • Ventilation-perfusion scan, also called a VQ scan

Preparing at home

There are also things you can do ahead of time at home to prepare for your pneumonectomy. Talk with your surgeon’s office about specific instructions for the following:

  • Quitting smoking before surgery
  • Stopping or adjusting medications
  • Planning for a support person as you recover from surgery
  • Including exercise in your daily routine
  • Participating in pulmonary rehabilitation
  • Using an incentive spirometer for breathing exercises
  • Avoiding eating or drinking the night before and the morning of surgery

What to expect during a pneumonectomy

A pneumonectomy is performed under general anesthesia, which means you’ll be asleep during your surgery. Most pneumonectomies use a traditional open surgical approach and take several hours. If you have an extrapleural pneumonectomy, your procedure may be longer than a standard pneumonectomy.

As a pneumonectomy procedure is a major surgery, you will initially recover in the hospital. Most people spend five to 10 days in the hospital after their procedure.

Risk and complications

Most people who have a pneumonectomy have a smooth recovery. However, pneumonectomy is a major surgery, and it is considered a higher-risk surgery than other less invasive options. This procedure benefits people with serious lung conditions, but your doctor will discuss whether these benefits outweigh any potential risks or complications.

Some of the risks of pneumonectomy include:

  • A blood clot in the lung, called pulmonary embolism
  • Respiratory failure
  • Infections, including pneumonia
  • Heart issues, such as heart attack or arrhythmia
  • Excessive bleeding
  • Air leak in the chest
  • Post-pneumonectomy syndrome, where organs shift too much in the chest after a lung is removed and block the airway.
  • An abnormal connection between the bronchus and the chest cavity
  • Injury to nearby tissues, including the diaphragm, trachea, vocal cords or blood vessels.
  • Shock
  • Side effects from anesthesia
Healthcare provider explaining risks and complications of pneumonectomy to older female patient, with a comforting hand on her shoulder

Frequently asked questions