Traditional medicine

How to quickly recover after lung surgery. Postoperative period

All materials on the site were prepared by specialists in the field of surgery, anatomy and specialized disciplines.
All recommendations are indicative in nature and are not applicable without consulting a doctor.

The need for lung surgery always causes reasonable fear in both the patient and his relatives. On the one hand, the intervention itself is quite traumatic and risky, on the other hand, operations on the respiratory organs are indicated for persons with serious pathology, which without treatment can lead to the death of the patient.

Surgical treatment of lung diseases places high demands on the general condition of the patient, since it is often accompanied by major surgical trauma and a long period of rehabilitation. Interventions of this kind should be taken seriously, paying due attention to both preoperative preparation and subsequent recovery.

The lungs are a paired organ located in the thoracic (pleural) cavities. Life without them is impossible, because the main function of the respiratory system is to deliver oxygen to all tissues of the human body and remove carbon dioxide. At the same time, having lost part or even the whole lung, the body can successfully adapt to new conditions, and the remaining part of the pulmonary parenchyma is able to take on the function of the lost tissue.

The type of lung surgery depends on the nature of the disease and its prevalence. If possible, surgeons preserve the maximum volume of respiratory parenchyma, unless this contradicts the principles of radical treatment. In recent years, modern minimally invasive techniques have been successfully used to remove lung fragments through small incisions, which contributes to a faster recovery and a shorter recovery period.

When is lung surgery necessary?

Lung operations are performed if there is a serious reason for this. Indications include:

The most common causes of lung surgery are tumors and some forms of tuberculosis. For lung cancer, surgery includes not only the removal of a part or an entire organ, but also excision of the lymphatic drainage pathways - the intrathoracic lymph nodes. In case of extensive tumors, resection of the ribs and areas of the pericardium may be required.

types of operations for surgical treatment of lung cancer

The types of lung interventions depend on the amount of tissue removed. Thus, a pulmonectomy is possible - removal of an entire organ, or resection - excision of a fragment of the lung (lobe, segment). With the widespread nature of the lesion, massive cancer, disseminated forms of tuberculosis, it is impossible to rid the patient of the pathology by removing only a fragment of the organ, therefore radical treatment is indicated - pneumonectomy. If the disease is limited to a lobe or segment of the lung, then it is enough to excise only them.

Traditional open surgeries are performed in cases where the surgeon is forced to remove a large volume of an organ. Recently, they are giving way to minimally invasive interventions, which make it possible to excise the affected tissue through small incisions - thoracoscopy. Among modern minimally invasive methods of surgical treatment, the use of laser, electric knife, and freezing are gaining popularity.
Features of operations

When performing interventions on the lung, accesses are used that provide the shortest path to the pathological focus:
Anterolateral;

Side;

Posterolateral.

Anterolateral approach means an arcuate incision between the 3rd and fourth ribs, starting slightly lateral from the parasternal line, extending to the posterior axilla. Posterolateral lead from the middle of the third or fourth thoracic vertebrae, along the paravertebral line to the angle of the scapula, then along the sixth rib to the anterior axillary line. Side cut is carried out when the patient lies on the healthy side, from the midclavicular line to the paravertebral line, at the level of the fifth-sixth rib.
Sometimes, in order to reach the pathological focus, sections of the ribs have to be removed. Today, it has become possible to excise not only a segment, but also an entire lobe thoracoscopically, when the surgeon makes three small incisions of about 2 cm and one up to 10 cm, through which instruments are inserted into the pleural cavity.
Pulmonectomy

Pulmonectomy is an operation to remove the lung, which is used in cases of damage to all its lobes in common forms of tuberculosis, cancer, and purulent processes. This is the most significant operation in terms of volume, because the patient loses an entire organ at once.

The right lung is removed from the anterolateral or posterior approach. Once in the chest cavity, the surgeon first ties up the elements of the lung root individually: first the artery, then the vein, and the bronchus is the last to be ligated. It is important that the bronchial stump is not too long, because this creates a risk of stagnation of contents in it, infection and suppuration, which can cause failure of the sutures and inflammation in the pleural cavity. The bronchial tube is stitched with silk or sutures are applied using a special device - a bronchial stitcher. After ligating the elements of the lung root, the affected organ is removed from the chest cavity.

When the bronchial stump is sutured, it is necessary to check the tightness of the sutures, which is achieved by pumping air into the lungs. If everything is in order, then the area of the vascular bundle is covered with pleura, and the pleural cavity is sutured, leaving drainage in it.
The left lung is usually removed through an anterolateral approach. The left main bronchus is longer than the right, so the doctor must be careful that its stump does not turn out to be long. The vessels and bronchus are treated in the same way as on the right side.
Pulmonectomy (pneumonectomy) is performed not only on adults, but also on children, but age does not play a decisive role in the choice of surgical technique, and the type of operation is determined by the disease (bronchiectasis, polycystic lung disease, atelectasis). In case of severe pathology of the respiratory system, requiring surgical correction, expectant management is not always justified, since many processes can disrupt the growth and development of a child if not treated in a timely manner.
Lung removal is performed under general anesthesia. It is necessary to administer muscle relaxants and tracheal intubation for ventilation of the organ parenchyma. In the absence of an obvious inflammatory process, drainages may not be left, and the need for them arises when pleurisy or other effusion appears in the chest cavity.
Lobectomy

A lobectomy is the removal of one lobe of the lung, and if two lobes are removed at once, the operation will be called a bilobectomy. This is the most common type of lung surgery. Indications for lobectomy are tumors limited to a lobe, cysts, some forms of tuberculosis, and isolated bronchiectasis. Lobectomy is also performed in cases of oncopathology, when the tumor is local in nature and does not spread to surrounding tissues.

lobectomy

The right lung includes three lobes, the left - two. The upper and middle lobes of the right and the upper lobe of the left are removed from the anterolateral approach, the lower lobe of the lung is removed from the posterolateral one.
After opening the chest cavity, the surgeon finds the vessels and bronchus, ligating them separately in the most minimally traumatic manner. First, the vessels are processed, then the bronchus, which is sutured with a thread or bronchial stitch. After these manipulations, the bronchus is covered with pleura, and the surgeon removes a lobe of the lung.
After a lobectomy, it is important to straighten the remaining lobes during surgery. To do this, oxygen is pumped into the lungs under high pressure. After the operation, the patient will have to independently straighten the lung parenchyma by performing special exercises.

After lobectomy, drains are left in the pleural cavity. During upper lobectomy, they are installed through the third and eighth intercostal space, and when removing the lower lobes, one drain inserted into the eighth intercostal space is sufficient.
Segmentectomy

A segmentectomy is an operation to remove part of the lung, called a segment.. Each lobe of the organ consists of several segments that have their own artery, vein and segmental bronchus. It is an independent pulmonary unit that can be excised safely for the rest of the organ. To remove such a fragment, use any of the approaches that provide the shortest possible path to the affected area of the lung tissue.
Indications for segmentectomy include small lung tumors that do not extend beyond the segment, lung cysts, small segmental abscesses and tuberculous cavities.

After dissecting the chest wall, the surgeon isolates and ligates the segmental artery, vein, and lastly the segmental bronchus. Isolation of a segment from the surrounding tissue should be done from the center to the periphery. At the end of the operation, drainage is installed in the pleural cavity according to the affected area, and the lung is inflated with air. If a large number of gas bubbles are released, the lung tissue is sutured. X-ray control is required before closing the surgical wound.
Pneumolysis and pneumotomy

Some operations on the lungs are aimed at eliminating pathological changes, but are not accompanied by the removal of its parts. These include pneumolysis and pneumotomy.
Pneumolysis is an operation to cut adhesions that prevent the lung from expanding and filling with air. A strong adhesive process accompanies tumors, tuberculosis, suppurative processes in the pleural cavities, fibrinous pleurisy in kidney pathology, extrapulmonary neoplasms. Most often, this type of operation is performed for tuberculosis, when abundant dense adhesions are formed, but the size of the cavity should not exceed 3 cm, that is, the disease should be limited in nature. Otherwise, a more radical intervention may be required - lobectomy, segmentectomy.
Dissection of adhesions is carried out extrapleurally, intrapleurally or extraperiosteally. At extrapleural In pneumolysis, the surgeon peels off the parietal pleural layer (outer) and introduces air or petroleum jelly into the chest cavity to prevent the lung from inflating and the formation of new adhesions. Intrapleural dissection of adhesions is carried out by penetration under the parietal pleura. Extraperiosteal the method is traumatic and has not been widely used. It involves peeling off the muscle flap from the ribs and introducing polymer beads into the resulting space.
The adhesions are cut using a hot loop. Instruments are inserted into the part of the chest cavity where there are no adhesions (under X-ray control). To gain access to the serous membrane, the surgeon resects sections of the ribs (the fourth for upper lobe lesions, the eighth for lower lobe lesions), peels off the pleura and sutures the soft tissue. The entire treatment process takes up to one and a half to two months.
lung abscess

Pneumotomy is another type of palliative surgery, which is indicated for patients with focal purulent processes - abscesses. An abscess is a cavity filled with pus, which can be evacuated by opening the chest wall.
Pneumotomy is also indicated for patients with tuberculosis, tumors and other processes that require radical treatment, but which is impossible due to their serious condition. Pneumotomy in this case is intended to make the patient feel better, but will not help completely eliminate the pathology.
Before performing a pneumotomy, the surgeon must perform a thoracoscopy to find the shortest path to the pathological focus. Then the rib fragments are resected. When access to the pleural cavity is obtained and provided that there are no dense adhesions in it, the latter is tamponed (the first stage of the operation). After about a week, the lung is dissected, and the edges of the abscess are fixed to the parietal pleura, which ensures the best outflow of pathological contents. The abscess is treated with antiseptics, leaving tampons soaked in a disinfectant in it. If there are dense adhesions in the pleural cavity, then pneumotomy is performed in one stage.
Before and after surgery

Surgeries on the lungs are traumatic, and the condition of patients with pulmonary pathology is often severe, so proper preparation for the upcoming treatment is very important. In addition to standard procedures, including a general blood and urine test, biochemical blood test, coagulogram, and lung x-ray, CT, MRI, fluoroscopy, and ultrasound examination of the chest organs may be required.
In case of purulent processes, tuberculosis or tumors, by the time of the operation the patient is already taking antibiotics, anti-tuberculosis drugs, cytostatics, etc. An important point in preparing for lung surgery is breathing exercises. In no case should it be neglected, since it not only promotes the evacuation of contents from the lungs even before the intervention, but is also aimed at straightening the lungs and restoring respiratory function after treatment.
In the preoperative period, a physical therapy methodologist helps you perform exercises. A patient with abscesses, cavities, or bronchiectasis should turn and bend the body while simultaneously raising the arm. When the sputum reaches the bronchus and causes a cough reflex, the patient bends forward and down, facilitating its removal with a cough. Weakened and bedridden patients can perform exercises while lying in bed, with the head end of the bed lowered slightly.
Postoperative rehabilitation takes on average about two weeks, but can last longer, depending on the pathology. It includes treatment of the postoperative wound, changing bandages, tampons for pneumotomy, etc., adherence to the regimen and exercise therapy.
The consequences of the treatment may include respiratory failure, secondary purulent processes, bleeding, suture failure and pleural empyema. To prevent them, antibiotics and painkillers are prescribed, and discharge from the wound is monitored. Breathing exercises are required, which the patient will continue to perform at home. The exercises are performed with the help of an instructor, and should be started within a couple of hours from the moment you emerge from anesthesia.
Life expectancy after surgical treatment of lung diseases depends on the type of intervention and the nature of the pathology. Thus, when single cysts, small tuberculosis lesions, and benign tumors are removed, patients live as long as other people. In the case of cancer, severe purulent process, lung gangrene, death can occur from septic complications, bleeding, respiratory and heart failure at any time after the intervention, if it did not contribute to achieving a stable condition.
If the operation is successfully performed and there are no complications or progression of the disease, the prognosis is generally good. Of course, the patient will need to monitor his respiratory system, smoking is out of the question, breathing exercises will be needed, but with the right approach, healthy lobes of the lungs will provide the body with the necessary oxygen.

Disability after lung surgery reaches 50% or more and is indicated for patients after pneumonectomy, in some cases after lobectomy, when the ability to work is impaired. The group is assigned in accordance with the patient's condition and is periodically reviewed. After a long period of rehabilitation, most of those operated on regain both health and ability to work. If the patient has recovered and is ready to return to work, then the disability can be lifted.
Lung operations are usually performed free of charge, because this is required by the severity of the pathology, and not by the patient’s desire. Treatment is available in thoracic surgery departments, and many operations are performed under the compulsory medical insurance system. However, the patient can undergo paid treatment in both public and private clinics, paying for both the operation itself and comfortable conditions in the hospital. The cost varies, but it cannot be low, because lung surgery is complex and requires the participation of highly qualified specialists. On average, pneumonectomy costs about 45-50 thousand, and for excision of mediastinal lymph nodes - up to 200-300 thousand rubles. Removing a lobe or segment will cost from 20 thousand rubles in a public hospital and up to 100 thousand in a private clinic.

Lung surgery requires preparation from the patient and compliance with recovery measures after its completion. They resort to removing the lung in severe cases of cancer. Oncology develops unnoticed and can manifest itself in a malignant state. Often people do not go to the doctor for minor ailments that indicate the progression of the disease.

Types of surgery

Lung surgery is performed only after a complete diagnosis of the patient’s body. Doctors are required to make sure that the procedure they perform is safe for a person who has a tumor. Surgical treatment should take place immediately, before the cancer spreads further throughout the body.

Lung surgery is of the following types:

Lobectomy - removal of the tumor part of the organ. Pulmonectomy involves the complete excision of one of the lungs. Wedge resection - targeted surgery of the chest tissue.

For patients, lung surgery seems like a death sentence. After all, a person cannot imagine that his chest will be empty. However, surgeons try to reassure patients; there is nothing scary about it. Concerns about difficulty breathing are unfounded.

Preliminary preparation for the procedure

An operation to remove a lung requires preparation, the essence of which boils down to diagnosing the condition of the remaining healthy part of the organ. After all, you need to be sure that after the procedure the person will be able to breathe as before. An incorrect decision can lead to disability or death. General well-being is also assessed; not every patient can withstand anesthesia.

The doctor will need to collect tests:

urine; results of a study of blood parameters; chest x-ray; ultrasound examination of the respiratory organ.

Additional research may be required if the patient has diseases of the heart, digestive or endocrine system. Drugs that thin the blood are prohibited. At least 7 days must pass before the operation. The patient goes on a therapeutic diet; bad habits will need to be eliminated before visiting the clinic and after for a long period of recovery of the body.

The essence of chest surgery

Surgical removal takes place for a long time under anesthesia of at least 5 hours. Using the photographs, the surgeon finds a place to make an incision with a scalpel. The tissue of the chest and the pleura of the lung are dissected. The adhesions are cut off and the organ is released for removal.

The surgeon uses clamps to stop bleeding. The drugs used in anesthesia are checked in advance so as not to cause anaphylactic shock. Patients may have an acute allergic reaction to the active substance.

After removing the entire lung, the artery is fixed with a clamp, then nodes are applied. The sutures are made with absorbable sutures that do not require removal. Inflammation is prevented by saline solution pumped into the chest: into the cavity that is located between the pleura and the lung. The procedure ends with a forced increase in pressure in the tracts of the respiratory system.

Recovery period

After lung surgery, precautions must be taken. The entire period takes place under the supervision of the surgeon who performed the procedure. After a few days, mobility-restoring exercises begin.

Breathing movements are carried out while lying down, sitting and while walking. The goal is simple - to shorten the treatment period by restoring the pectoral muscles weakened by anesthesia. Home therapy is not painless; constricted tissues are gradually released.

In case of severe pain, it is allowed to use painkillers. Any swelling, purulent complications or lack of inhaled air should be eliminated together with the attending physician. Discomfort when moving the chest persists for up to two months, which is a normal course of the recovery period.

Additional assistance during rehabilitation

The patient spends several days in bed after the operation. Removing a lung has unpleasant consequences, but simple remedies help avoid the development of inflammation:

The dropper supplies the body with anti-inflammatory substances, vitamins, and the required amount of fluid for the normal functioning of internal organs and maintaining metabolic processes at the proper level. You will need to install tubes in the incision area, fixed with a bandage between the ribs. The surgeon may leave them in place for the entire first week. You will have to put up with the inconvenience for the sake of your future health.

If lung cancer has already been removed, after the operation there will be about a week of hospital treatment. After being discharged, continue to do physical exercises and take anti-inflammatory drugs until the stitch disappears completely.

Prerequisites for treatment by a surgeon

Tumors in the lungs appear due to the following factors:

Tuberculosis. Cyst. Echinococcosis. Fungi. Injuries.

Infections are on a par with other provocateurs: bad habits (smoking, alcoholism), chronic diseases (thrombosis, diabetes), obesity, long-term medication therapy, severe allergic reactions. The lungs are checked periodically for timely detection of pathological conditions.

Thus, it is recommended to examine the lungs once a year. Particular attention is paid to patients suffering from vascular diseases. If the disease is started, dying tumor tissue will provoke further growth of pathological cells. Inflammation will spread to neighboring organs or travel deep into the body through the bloodstream.

The cyst in the lungs does not remain in its original form. It gradually grows, squeezing the sternum. There is discomfort and pain. The compressed tissue begins to die, causing the appearance of purulent foci. Similar consequences are observed after injury, rib fracture.

Can the diagnosis be wrong?

In very rare cases, a diagnostic error occurs with the conclusion “lung tumor”. Surgery in such situations may not be the only option. However, doctors still resort to removing the lung for reasons of preserving human health.

In case of severe complications, it is recommended to remove the affected tissue. The decision about surgery is made based on clinical symptoms and photographs. The pathological part is removed to stop the growth of tumor cells. There are cases of miraculous healing, but it is unreasonable to hope for such an outcome. Surgeons are used to being realistic, because we are talking about saving the patient’s life.

When is lung surgery necessary?

Lung operations are performed if there is a serious reason for this. Indications include:

types of operations for surgical treatment of lung cancer

Traditional open surgeries are performed in cases where the surgeon is forced to remove a large volume of an organ. Recently, they are giving way to minimally invasive interventions that allow excision of the affected tissue through small incisions - thoracoscopy. Among modern minimally invasive methods of surgical treatment, the use of laser, electric knife, and freezing are gaining popularity.

Features of operations

When performing interventions on the lung, accesses are used that provide the shortest path to the pathological focus:

Anterolateral; Side; Posterolateral.

The anterolateral approach means an arcuate incision between the 3rd and fourth ribs, starting slightly lateral from the parasternal line, extending to the posterior axilla. The posterolateral one leads from the middle of the third and fourth thoracic vertebrae, along the paravertebral line to the angle of the scapula, then along the sixth rib to the anterior axillary line. A lateral incision is made with the patient lying on the healthy side, from the midclavicular line to the paravertebral line, at the level of the fifth or sixth rib.

Sometimes, in order to reach the pathological focus, sections of the ribs have to be removed. Today, it has become possible to excise not only a segment, but also an entire lobe thoracoscopically, when the surgeon makes three small incisions of about 2 cm and one up to 10 cm, through which instruments are inserted into the pleural cavity.

Pulmonectomy

Pulmonectomy is an operation to remove the lung, which is used in cases of damage to all its lobes in common forms of tuberculosis, cancer, and purulent processes. This is the most significant operation in terms of volume, because the patient loses an entire organ at once.

The right lung is removed from the anterolateral or posterior approach. Once in the chest cavity, the surgeon first ties up the elements of the lung root individually: first the artery, then the vein, and the bronchus is the last to be ligated. It is important that the bronchial stump is not too long, because this creates a risk of stagnation of contents in it, infection and suppuration, which can cause failure of the sutures and inflammation in the pleural cavity. The bronchial tube is stitched with silk or sutures are applied using a special device - a bronchial stitcher. After ligating the elements of the lung root, the affected organ is removed from the chest cavity.

When the bronchial stump is sutured, it is necessary to check the tightness of the sutures, which is achieved by pumping air into the lungs. If everything is in order, then the area of the vascular bundle is covered with pleura, and the pleural cavity is sutured, leaving drainage in it.

The left lung is usually removed through an anterolateral approach. The left main bronchus is longer than the right, so the doctor must be careful that its stump does not turn out to be long. The vessels and bronchus are treated in the same way as on the right side.

Pulmonectomy (pneumonectomy) is performed not only on adults, but also on children, but age does not play a decisive role in the choice of surgical technique, and the type of operation is determined by the disease (bronchiectasis, polycystic lung disease, atelectasis). In case of severe pathology of the respiratory system, requiring surgical correction, expectant management is not always justified, since many processes can disrupt the growth and development of a child if not treated in a timely manner.

Removal of the lung is performed under general anesthesia; administration of muscle relaxants and tracheal intubation are required to ventilate the parenchyma of the organ. In the absence of an obvious inflammatory process, drainages may not be left, and the need for them arises when pleurisy or other effusion appears in the chest cavity.

Lobectomy

A lobectomy is the removal of one lobe of the lung, and if two lobes are removed at once, the operation will be called a bilobectomy. This is the most common type of lung surgery. Indications for lobectomy are tumors limited to a lobe, cysts, some forms of tuberculosis, and isolated bronchiectasis. Lobectomy is also performed in cases of oncopathology, when the tumor is local in nature and does not spread to surrounding tissues.

lobectomy

The right lung includes three lobes, the left - two. The upper and middle lobes of the right and the upper lobe of the left are removed from the anterolateral approach, the lower lobe of the lung is removed from the posterolateral one.

After opening the chest cavity, the surgeon finds the vessels and bronchus, ligating them separately in the most minimally traumatic manner. First, the vessels are processed, then the bronchus, which is sutured with a thread or bronchial stitch. After these manipulations, the bronchus is covered with pleura, and the surgeon removes a lobe of the lung.

After a lobectomy, it is important to straighten the remaining lobes during surgery. To do this, oxygen is pumped into the lungs under high pressure. After the operation, the patient will have to independently straighten the lung parenchyma by performing special exercises.

After lobectomy, drains are left in the pleural cavity. During upper lobectomy, they are installed through the third and eighth intercostal space, and when removing the lower lobes, one drain inserted into the eighth intercostal space is sufficient.

Segmentectomy

A segmentectomy is an operation to remove part of the lung, called a segment.. Each lobe of the organ consists of several segments that have their own artery, vein and segmental bronchus. It is an independent pulmonary unit that can be excised safely for the rest of the organ. To remove such a fragment, use any of the approaches that provide the shortest possible path to the affected area of the lung tissue.

Indications for segmentectomy include small lung tumors that do not extend beyond the segment, lung cysts, small segmental abscesses and tuberculous cavities.

After dissecting the chest wall, the surgeon isolates and ligates the segmental artery, vein, and lastly the segmental bronchus. Isolation of a segment from the surrounding tissue should be done from the center to the periphery. At the end of the operation, drainage is installed in the pleural cavity according to the affected area, and the lung is inflated with air. If a large number of gas bubbles are released, the lung tissue is sutured. X-ray control is required before closing the surgical wound.

Pneumolysis and pneumotomy

Some operations on the lungs are aimed at eliminating pathological changes, but are not accompanied by the removal of its parts. These include pneumolysis and pneumotomy.

Pneumolysis is an operation to cut adhesions that prevent the lung from expanding and filling with air. A strong adhesive process accompanies tumors, tuberculosis, suppurative processes in the pleural cavities, fibrinous pleurisy in kidney pathology, extrapulmonary neoplasms. Most often, this type of operation is performed for tuberculosis, when abundant dense adhesions are formed, but the size of the cavity should not exceed 3 cm, that is, the disease should be limited in nature. Otherwise, a more radical intervention may be required - lobectomy, segmentectomy.

Dissection of adhesions is carried out extrapleurally, intrapleurally or extraperiosteally. With extrapleural pneumolysis, the surgeon peels off the parietal pleural layer (outer) and injects air or petroleum jelly into the chest cavity to prevent the lung from inflating and the formation of new adhesions. Intrapleural dissection of adhesions is performed by penetrating the parietal pleura. The extraperiosteal method is traumatic and has not been widely used. It involves peeling off the muscle flap from the ribs and introducing polymer beads into the resulting space.

The adhesions are cut using a hot loop. Instruments are inserted into the part of the chest cavity where there are no adhesions (under X-ray control). To gain access to the serous membrane, the surgeon resects sections of the ribs (the fourth for upper lobe lesions, the eighth for lower lobe lesions), peels off the pleura and sutures the soft tissue. The entire treatment process takes up to one and a half to two months.

lung abscess

Pneumotomy is another type of palliative surgery, which is indicated for patients with focal purulent processes - abscesses. An abscess is a cavity filled with pus, which can be evacuated by opening the chest wall.

Pneumotomy is also indicated for patients with tuberculosis, tumors and other processes that require radical treatment, but which is impossible due to their serious condition. Pneumotomy in this case is intended to make the patient feel better, but will not help completely eliminate the pathology.

Before performing a pneumotomy, the surgeon must perform a thoracoscopy to find the shortest path to the pathological focus. Then the rib fragments are resected. When access to the pleural cavity is obtained and provided that there are no dense adhesions in it, the latter is tamponed (the first stage of the operation). After about a week, the lung is dissected, and the edges of the abscess are fixed to the parietal pleura, which ensures the best outflow of pathological contents. The abscess is treated with antiseptics, leaving tampons soaked in a disinfectant in it. If there are dense adhesions in the pleural cavity, then pneumotomy is performed in one stage.

Before and after surgery

Surgeries on the lungs are traumatic, and the condition of patients with pulmonary pathology is often severe, so proper preparation for the upcoming treatment is very important. In addition to standard procedures, including a general blood and urine test, biochemical blood test, coagulogram, and lung x-ray, CT, MRI, fluoroscopy, and ultrasound examination of the chest organs may be required.

In case of purulent processes, tuberculosis or tumors, by the time of the operation the patient is already taking antibiotics, anti-tuberculosis drugs, cytostatics, etc. An important point in preparing for lung surgery is breathing exercises. In no case should it be neglected, since it not only promotes the evacuation of contents from the lungs even before the intervention, but is also aimed at straightening the lungs and restoring respiratory function after treatment.

In the preoperative period, a physical therapy methodologist helps you perform exercises. A patient with abscesses, cavities, or bronchiectasis should turn and bend the body while simultaneously raising the arm. When the sputum reaches the bronchus and causes a cough reflex, the patient bends forward and down, facilitating its removal with a cough. Weakened and bedridden patients can perform exercises while lying in bed, with the head end of the bed lowered slightly.

Postoperative rehabilitation takes on average about two weeks, but can last longer, depending on the pathology. It includes treatment of the postoperative wound, changing bandages, tampons for pneumotomy, etc., adherence to the regimen and exercise therapy.

The consequences of the treatment may include respiratory failure, secondary purulent processes, bleeding, suture failure and pleural empyema. To prevent them, antibiotics and painkillers are prescribed, and discharge from the wound is monitored. Breathing exercises are required, which the patient will continue to perform at home. The exercises are performed with the help of an instructor, and should be started within a couple of hours from the moment you emerge from anesthesia.

Life expectancy after surgical treatment of lung diseases depends on the type of intervention and the nature of the pathology. Thus, when single cysts, small tuberculosis lesions, and benign tumors are removed, patients live as long as other people. In the case of cancer, severe purulent process, lung gangrene, death can occur from septic complications, bleeding, respiratory and heart failure at any time after the intervention, if it did not contribute to achieving a stable condition.

If the operation is successfully performed and there are no complications or progression of the disease, the prognosis is generally good. Of course, the patient will need to monitor his respiratory system, smoking is out of the question, breathing exercises will be needed, but with the right approach, healthy lobes of the lungs will provide the body with the necessary oxygen.

Disability after lung surgery reaches 50% or more and is indicated for patients after pneumonectomy, in some cases after lobectomy, when the ability to work is impaired. The group is assigned in accordance with the patient's condition and is periodically reviewed. After a long period of rehabilitation, most of those operated on regain both health and ability to work. If the patient has recovered and is ready to return to work, then the disability can be lifted.

Lung operations are usually performed free of charge, because this is required by the severity of the pathology, and not by the patient’s desire. Treatment is available in thoracic surgery departments, and many operations are performed under the compulsory medical insurance system. However, the patient can undergo paid treatment in both public and private clinics, paying for both the operation itself and comfortable conditions in the hospital. The cost varies, but it cannot be low, because lung surgery is complex and requires the participation of highly qualified specialists. On average, pneumonectomy costs about 45-50 thousand, and for excision of mediastinal lymph nodes - up to 200-300 thousand rubles. Removing a lobe or segment will cost from 20 thousand rubles in a public hospital and up to 100 thousand in a private clinic.

Pulmonary diseases are very diverse, and doctors use different methods to treat them. In some cases, therapeutic measures are ineffective, and surgery has to be used to overcome a dangerous disease.

Lung operations are a forced measure that is used in difficult situations when there is no other way to cope with the pathology. But many patients experience anxiety when they find out they need such surgery. Therefore, it is important to know what such an intervention is, whether it is dangerous, and how it will affect a person’s future life.

It should be said that chest surgery using the latest technologies does not pose any threat to health. But this is only true if the doctor performing the procedure has a sufficient level of qualifications, and if all precautions are followed. In this case, even after serious surgery, the patient will be able to recover and live a full life.

Indications and types of operations

Lung operations are not performed unless absolutely necessary. The doctor first makes attempts to cope with the problem without using radical measures. However, there are situations when surgery is necessary. This:

congenital abnormalities; pulmonary injuries; presence of neoplasms (malignant and non-malignant); pulmonary tuberculosis in severe form; cysts; pulmonary infarction; abscess; atelectasis; pleurisy, etc.

In any of these cases, it is difficult to cope with the disease using only medications and therapeutic procedures. However, at the initial stage of the disease, these methods can be effective, which is why it is so important to seek help from a specialist in a timely manner. This will avoid the use of radical treatment measures. So, even if these difficulties are present, surgery may not be prescribed. The doctor must take into account the characteristics of the patient, the severity of the disease and many other factors before making such a decision.

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Operations performed for lung diseases are divided into 2 groups. This:

Pneumoectomy. Otherwise, this operation is called pneumonectomy. It involves complete removal of the lung. It is prescribed in the presence of a malignant tumor in one lung or in cases of widespread pathological foci in the lung tissues. In this case, it is easier to remove the entire lung than to separate the damaged areas. Removing a lung is the most significant operation because half of the organ is eliminated.

This type of intervention is practiced not only for adults, but also for children. In some cases, when the patient is a child, the decision to perform such an operation is made even faster, since pathological processes in the damaged organ interfere with the normal development of the body. An operation to remove the lung is performed under general anesthesia.

Lung resection. This type of intervention involves removing part of the lung, the one in which the focus of the pathology is located. There are several types of lung resection. This:

atypical lung resection. Another name for this operation is marginal lung resection. During it, one section of the organ located on the edge is removed; segmentectomy. Such resection of the lungs is practiced when a separate segment is damaged along with the bronchus. The intervention involves removing this area. Most often, when performing it, there is no need to cut the chest, and the necessary actions are performed using an endoscope; lobectomy. This type of operation is practiced when the pulmonary lobe is affected, which has to be removed surgically; bilobectomy. During this operation, two lobes of the lung are removed; Removing a lobe of a lung (or two) is the most common type of intervention. The need for it arises in the presence of tuberculosis, cysts, tumors localized within one lobe, etc. Such lung resection can be performed in a minimally invasive way, but the decision should remain with the doctor; reduction. In this case, it is assumed that non-functioning lung tissue is removed, thereby reducing the size of the organ.

According to intervention technologies, such operations can be divided into two more types. This:

Thoracotomy surgery. During its implementation, a wide opening of the chest is performed to perform manipulations. Thoracoscopic surgery. This is a minimally invasive type of intervention in which there is no need to cut into the chest because an endoscope is used.

Lung transplant surgery, which appeared relatively recently, is discussed separately. It is carried out in the most difficult situations, when the patient’s lungs stop functioning, and without such intervention his death will occur.

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Life after surgery

It is difficult to say how long it will take the body to recover after surgery. This is influenced by many circumstances. It is especially important that the patient follows the doctor’s recommendations and avoids harmful effects, this will help minimize the consequences.

If there is only one lung left

Most often, patients are concerned with the question of whether it is possible to live with one lung. It is necessary to understand that doctors do not make the decision to remove half an organ unless necessary. Usually the patient’s life depends on this, so this measure is justified.

Modern technologies for various interventions allow one to obtain good results. A person who has undergone surgery to remove one lung can successfully adapt to new conditions. This depends on how correctly the pneumectomy was performed, as well as on the aggressiveness of the disease.

In some cases, the disease that caused the need for such measures returns, which becomes very dangerous. However, this is safer than trying to save the damaged area, from which the pathology can spread even further.

Another important aspect is that after a lung is removed, a person should visit a specialist for routine checkups.

This allows you to timely detect a relapse and begin treatment to prevent similar problems.

In half of the cases, after a pneumoectomy, people become disabled. This is done so that a person can avoid overexerting himself while performing his work duties. But receiving a disability group does not mean that it will be permanent.

After some time, disability can be canceled if the patient’s body has recovered. This means that living with one lung is possible. Of course, precautions will be required, but even in this case, a person has a chance to live a long time.

It is difficult to talk about the life expectancy of a patient who has undergone lung surgery. It depends on many circumstances, such as the form of the disease, timeliness of treatment, individual endurance of the body, compliance with preventive measures, etc. Sometimes a former patient is able to lead a normal life, limiting himself to virtually nothing.

Postoperative recovery

After any type of lung surgery has been performed, the patient’s respiratory function will be impaired for the first time, so recovery implies the return of this function to normal. This happens under the supervision of doctors, so primary rehabilitation after lung surgery involves the patient staying in the hospital. D

In order for breathing to normalize faster, special procedures, breathing exercises, medication and other measures may be prescribed. The doctor selects all these measures individually, taking into account the characteristics of each specific case.

A very important part of recovery measures is the patient’s nutrition. You should check with your doctor about what you can eat after surgery. Food shouldn't be heavy. But to restore strength, you need to eat healthy and nutritious food, which contains a lot of protein and vitamins. This will strengthen the human body and speed up the healing process.

In addition to the fact that proper nutrition is important during the recovery stage, other rules must be followed. This:

Complete rest.
No stressful situations. Avoiding strenuous physical effort. Carrying out hygiene procedures. Taking prescribed medications. Quitting bad habits, especially smoking. Frequent walks in the fresh air.

It is very important not to skip preventive examinations and inform your doctor about any adverse changes in the body.

nervousness, sleep and appetite disturbances... frequent colds, problems with the bronchi and lungs... headaches... bad breath, plaque on the teeth and tongue... changes in body weight... diarrhea, constipation and stomach pain... exacerbation of chronic diseases...

Bondarenko Tatyana

Expert of the OPnevmonii.ru project

Surgeries for cancer are performed quite often, in some cases this leads to the patient’s recovery and saving his life. Lung removal for cancer is used when the tumor is small in size and has not spread metastases to other organs and tissues. Before performing surgery, oncologists always prescribe examinations to determine the possibility of surgery on a given organ, as well as the patient’s ability to tolerate it. There is an opinion that with one lung it will be difficult for a person to breathe, but this is not so. A person can breathe just as well with one lung as with two, but if they have breathing problems before surgery, they can get much worse.

The need for surgery

Usually, surgery is used for non-small cell tumors, when the tumor is small and has not metastasized. Surgery to remove the lung usually occurs at the initial stage of the disease. The doctor prescribes all additional tests to make sure that the person is ready for surgery and that the consequences of treatment will be good. In this case, special attention is paid to the following points:

Survival after lung surgery averages 40%, provided the tumor is localized and grows slowly.
If the function of the heart and lungs is impaired, the risk of death after surgical treatment increases.
There is always a risk of complications and negative consequences after lung surgery.

Contraindications for surgery

Removing a lung can provoke the development of various complications, so it is not indicated for all patients. Surgery cannot be performed in the following cases:

advanced age;
spread of metastases throughout the body;
the presence of severe diseases of the heart and blood vessels, as well as other vital organs;
disorders of the respiratory and circulatory systems;
excess body weight.

Types of surgery

The choice of surgical method for lung carcinoma depends on the location of the cancer tumor and its size. During the operation, the patient's chest is opened, and then the affected organ is removed. The following types of operations are used in oncology:

Wedge resection, in which part of the affected lobe of the lung is removed. The purpose of resection is to remove the pathological tissue of the organ in such a way as to leave as much of the healthy area intact as possible. In this case, surgical treatment can save the organ and speed up the process of rehabilitation and recovery after removal of the lung for cancer.
A lobectomy is characterized by the removal of an entire lobe of the lung. During the operation, the surgeon also removes the lymph nodes in the chest. After the procedure is completed, drainage tubes are installed in the patient’s chest, through which accumulated fluid will be released from the chest cavity. The incision is then closed with sutures or staples.
A pneumonectomy involves removing the entire lung. Typically, this method is used in case of widespread pathology and large tumor size.

A segmentectomy is the removal of a segment of the lung. The operation is performed when the cancerous tumor is small and does not extend beyond the lung segment.

Pay attention! Pulmonectomy is the most important operation in terms of volume for lung cancer, since in this case a person loses an entire organ.

When using a surgical method of therapy, the patient must be hospitalized, and after the operation, he must be monitored for several more weeks or months. Methods of treatment and prevention are developed by the attending physician.

Rehabilitation period

Removing a lung for cancer can have various consequences, from breathing problems to the development of an infectious process. Most often, after surgery, patients experience weakness, breathing with pain, shortness of breath, and respiratory distress. In severe cases, bleeding and various complications may develop after the use of anesthesia.

The recovery period of the respiratory system lasts about two years. In this case, a person experiences a disorder in the anatomical connection of organs. The patient's physical activity decreases, which leads to an increase in body weight, which in turn increases the load on the respiratory system, and a constant cough appears.

If fluid accumulates in the cavity that remains after removal of the lung, it is removed using a puncture. The biopsy is then sent for histological examination.

In the postoperative period, the doctor prescribes exercise therapy to strengthen the chest walls and breathing exercises. It is also necessary to prescribe a diet after surgery.

Pay attention! Curing lung cancer is very difficult, but removing the lung gives a chance of survival. This can be achieved only with proper preparation for the operation, as well as following all the doctor’s recommendations and avoiding the influence of negative factors in the postoperative period.

Complications and negative consequences

Surgery always involves a risk of complications. In this case, a person may develop respiratory failure, secondary infectious diseases, and bleeding. With the development of an acute purulent process, for example, severe infectious bronchitis in adults, lung gangrene and sepsis may appear over time, which will lead to death. Such negative consequences can occur at any time after surgery if the patient's stable condition has not been achieved. If any unpleasant symptoms occur, you must urgently undergo examination.

Disability after lung removal develops in half of patients scheduled for pneumonectomy. After a long recovery period, most people regain their ability to work.

Pay attention! An equally common complication is cancer recurrence. The doctor cannot guarantee the complete removal of the tumor and the absence of cancer cells in the patient’s body. There is always a risk of tumor recurrence.

Prognosis and prevention of pathology

Lung cancer is a dangerous disease that leaves virtually no chance of normal life. Usually a person experiences severe pain, which brings him suffering, and death is often observed. Death is also possible after surgery; it occurs in 7% of operated patients.

Prevention of the disease should begin with giving up bad habits, in particular smoking, this also applies to passive smoking, which is also dangerous. It is also recommended to avoid radiation exposure, exposure to carcinogens, and promptly treat respiratory diseases. Doctors insist on annual fluorography, which makes it possible to detect abnormalities in the lungs in the early stages of the development of pathology.

Unfortunately, in case of lung injuries, diseases or complications, surgical intervention is sometimes necessary. After surgical treatment, a long recovery period is needed, which is helped by breathing exercises, exercise therapy, and special gymnastic exercises. After dangerous injuries that occur as a result of damage to the bone corset of the chest, a rib injury to the lung is possible, as well as damage to the circulatory system and air entering the cavity behind the pleura. Surgeries are also needed for lung suppuration and tumors, and it is possible to remove part or all of the lung. Moreover, the operations themselves are very traumatic - to get to the respiratory organ, you need to go through the muscles, cartilage and the ribs themselves. Surgeons restore tightness and respiratory function, but you need to restore the functionality and fullness of breathing yourself.

Before surgery

People usually have a very difficult time undergoing lung surgery, so it is advisable to prepare them for this traumatic intervention with the help of gymnastics and physical exercises. Special exercises are especially helpful for suppuration in the lungs, which cause intoxication. Due to the accumulation of pus in the lungs, which is accompanied by hemoptysis, it becomes harder to breathe, and the human heart and brain work worse. Special physical activity helps improve respiratory functions. Exercises to do after surgery are also covered.

Of course, if there is bleeding in the lungs, the body temperature rises above 38 degrees, but without accumulation of sputum, or third-degree cardiovascular insufficiency is diagnosed, there can be no question of any therapeutic exercises, since it can be harmful and possibly , the patient needs to be operated on urgently.

After surgery

During surgery, internal organs suffer serious injuries. Not only muscles and ribs are damaged, but also nerve endings, which leads to pain after surgery, which, together with depression of the respiratory center, leads to superficial gas exchange and impaired drainage of the lungs. After the operation, other complications also arise - contracture of the shoulder joint pain, embolism, thrombosis, pneumonia, intestinal atony, intestinal problems and others.

In the postoperative period, it is necessary to improve the performance of one part of the lung that has been preserved, to avoid complications, adhesions between the pleura, and to develop the shoulder joint. Therapeutic exercises are prescribed for several hours after the operation, including breathing exercises, since the patient must clear his throat.

Exercises in bed

Renewal Exercises

After the operation, you need to examine the lung to see if it has expanded sufficiently; if not, there may be inflammation of individual areas, which is preceded by shortness of breath. Therefore, check with your doctor regularly. Until three months you need to do exercises that ventilate the lungs. You can do your homework, you need to eat in moderation without overeating. And, since this is a restorative process, nutrition should be healthy. You need to quit smoking and drinking, of course.