Thoracic Surgery (Lung Resection, Pleurectomy)
Introduction
Thoracic surgery consists of procedures for the treatment of lung, pleura (lung lining), and chest wall disorders. Surgeons also frequently perform lung resection (tissue removal of the lung) and pleurectomy (removal of pleura) for lung tumors, chronic infections, and pleura disease. The purpose of these surgeries is to surgically excise diseased or damaged tissue to improve lung function and general health.
What is Thoracic Surgery (Lung Resection, Pleurectomy)?
Lung Resection
- Lung resection is the procedure of deleting part or all of a lung to cure diseases such as lung cancer or chronic infections. The types of lung resection are:
- Wedge Resection: Removal of a small section of the lung.
- Lobectomy: Removal of a lobe of the lung.
- Pneumonectomy: Removal of an entire lung.
Pleurectomy
Pleurectomy is surgery in which the pleura (lining the lung) is surgically resected. The usual indication for using this procedure is the treatment of pleural diseases (e.g., pleural mesothelioma or chronic pleural effusion, pleural space filling due to dense fluid). Pleurectomy can be used in the context of lung resection for staging and curative treatment approaches.
Why is Thoracic Surgery (Lung Resection, Pleurectomy) Needed?
Such surgery is required when the lungs or pleura are grossly involved in disease. Common conditions that require these surgeries include:
- Lung Cancer: Local cancer where removing the portion of the lung involved is the best way to improve survival.
- Chronic Lung Diseases or Infections: Conditions that necessitate any breakdown of damaged tissue can impair lung function, improving the global health of the lungs.
- Pleural Disease: In pathologies such as mesothelioma or pleural effusion, doctors commonly perform pleurectomy to alleviate symptoms and halt disease progression.
Types of Thoracic Surgery (Lung Resection, Pleurectomy)
Thoracic surgeries may differ based on the disease being addressed. Common types include:
- Lung Resection: Wedge resection, lobectomy, or pneumonectomy, depending on the severity of the disease.
- Pleurectomy: Pleural disease is managed by the removal of the pleura either in part or in whole.
- Thoracotomy: Open surgical procedure with a very large incision into the chest.
- Video-Assisted Thoracic Surgery (VATS): A minimally invasive procedure that utilizes small incisions and a camera for increased accuracy and faster recovery.
Procedure Steps
Preoperative Evaluation: The surgeon conducts imaging tests (like CT scans) and other assessments to determine the extent of the disease.
- Anesthesia: The medical team instills general anesthesia to make the patient unconscious during the surgery.
- Incision and Access: The surgeon creates an incision (traditional or small for VATS) to access the lungs or pleura.
- Surgical Removal: Surgeons excise damaged lung tissue and pleura and (sometimes) remove lymph nodes to rule out metastases.
- Postoperative Care: The postoperative patient is observed for complications such as bleeding and infection. A chest tube may be placed to remove fluids or air.
Benefits of Thoracic Surgery (Lung Resection, Pleurectomy)
- Improved Survival Rate: For patients with lung cancer or locoregional disease, lung resection offers the possibility of cure.
- Symptom Relief: Surgery can treat symptoms, which are shortness of breath and chest pain, due to pleural disease or chronic lung disease.
- Minimally Invasive Options: VATS results in faster recovery, less pain and a shorter hospital stay.
- Better Lung Function: Surgeons excise damaged tissue, restoring more of the healthy lung tissue to perform better and thus improving the patient’s breath capacity.
Cost of Thoracic Surgery (Lung Resection, Pleurectomy)
Here’s how the cost of thoracic surgery compares internationally:
- India: $4,500 – $7,500
- USA: $15,000 – $30,000
- Germany: $12,000 – $22,000
- UK: $10,000 – $25,000
India provides a vastly affordable alternative to thoracic surgeries in countries such as the USA and the United Kingdom.
Thoracic Surgery Hospitals in India for Lung Resection and Pleurectomy.
Leading hospitals in India offering thoracic surgeries include:
- Fortis Memorial Research Institute (Delhi, Gurgaon)
- Medanta: The Medicity (Gurgaon)
- Max Super Specialty Hospital (Delhi)
These hospitals are known for their advanced technology and skilled thoracic surgeons.
Risks and Complications of Thoracic Surgery (Lung Resection, Pleurectomy)
As with any surgery, thoracic operations have associated risks, including:
- Infection: Infection at the surgical site is a potential risk.
- Bleeding: There may be bleeding during or after the surgery, requiring blood transfusions in some cases.
- Respiratory Issues: Complications such as impaired ventilation, lung collapse, or pneumonia may occur.
- Damage to Surrounding Tissues: The surgery may inadvertently affect nearby structures, such as blood vessels or nerves.
- Recurrence of Disease: Particularly in the case of lung cancer, the possibility of cancer recurrence after surgery exists.
Recovery After Thoracic Surgery (Lung Resection, Pleurectomy)
Postoperative Monitoring: After surgery, patients are monitored closely for complications like infection or bleeding. Pain management is also provided.
- Hospital Stay: Recovery generally requires 4–7 days in the hospital, depending on the surgery.
- Rehabilitation: Pulmonary rehabilitation may be an option to contract the lungs and reduce the effort of breathing.
- Full Recovery: Full restoration may occur over weeks or months based on the patient’s general health status and the scope of the operation.
