What are the symptoms of a Pancoast tumor. How is a Pancoast tumor diagnosed. What treatment options are available for Pancoast tumors. What is the prognosis for patients with Pancoast tumors.

Understanding Pancoast Tumors: A Rare Form of Lung Cancer

Pancoast tumors are a unique and rare type of lung cancer that develops at the very top of either lung. These tumors, also known as superior sulcus tumors, are typically classified as non-small cell lung cancers. What sets Pancoast tumors apart from other lung cancers is their location and tendency to invade surrounding tissues.

The distinctive positioning of Pancoast tumors at the lung apex results in the formation of an abnormal patch of tissue that primarily affects chest wall structures rather than the underlying lung tissue. This invasive nature can lead to the tumor spreading to nearby areas, including:

• Lymph nodes
• Nerves
• Ribs
• Spine

Risk Factors Associated with Pancoast Tumors

The risk factors for Pancoast tumors are similar to those of most lung cancers. Understanding these risk factors is crucial for prevention and early detection. The primary risk factors include:

1. Smoking: The most significant risk factor for lung cancer, including Pancoast tumors
2. Secondhand smoke exposure: Prolonged exposure to environmental tobacco smoke
3. Asbestos exposure: Long-term contact with asbestos fibers
4. Industrial element exposure: Prolonged exposure to substances such as chromium or nickel

Are there any genetic factors that increase the risk of developing Pancoast tumors? While specific genetic links have not been firmly established for Pancoast tumors, research suggests that certain genetic mutations may increase an individual’s susceptibility to lung cancer in general. However, environmental factors, particularly smoking, remain the most significant risk factors.

Recognizing the Symptoms of Pancoast Tumors

Identifying the symptoms of Pancoast tumors can be challenging, as they often differ from typical lung cancer symptoms. Due to their unique location, these tumors rarely cause common lung-related issues such as coughing or chest pain. Instead, the initial symptoms often manifest as:

• Severe and constant pain in the shoulder
• Pain in the inner part of the shoulder blades
• Pain that may extend to the inner side of the arm, elbow, and fingers (particularly the pinky and ring fingers)

As the tumor progresses, patients may experience additional symptoms:

• Weakness in the hand, arm, and forearm
• Muscle degeneration or shrinkage from disuse
• Sensations of pricking, tingling, or creeping on the skin

Can Pancoast tumors cause neurological symptoms? Yes, if the tumor extends to certain nerves, it can lead to a condition called Horner syndrome, which affects one side of the face and is characterized by:

• A drooping eyelid
• Absence of sweating on the affected side of the face
• Narrowing of the pupil

In severe cases, where the tumor extends into the opening between two vertebrae, it can compress the spinal cord, potentially leading to paralysis of the lower half of the body. This complication occurs in up to 25% of people with Pancoast tumors.

Diagnostic Approaches for Pancoast Tumors

Diagnosing Pancoast tumors can be challenging due to their location and atypical symptoms. Medical professionals employ various diagnostic tools and techniques to accurately identify and assess these tumors:

Imaging Studies

• Chest X-ray: Often the initial imaging study, though early-stage Pancoast tumors can be difficult to detect due to their location
• CT scan of the chest: Provides more detailed images and helps determine if the tumor has invaded nearby structures
• MRI of the chest: Offers the most accurate assessment of tumor growth and invasion of surrounding areas
• Arteriogram or venogram: Used in rare cases to evaluate involvement of blood vessels under the collarbone

Diagnostic Procedures

• Bronchoscopy: While not always helpful due to the peripheral location of Pancoast tumors, it can evaluate the tracheal and bronchial cavities
• Biopsy: The gold standard for diagnosis, typically performed via needle biopsy guided by X-ray or CT scan

Why is a biopsy crucial in diagnosing Pancoast tumors? A biopsy is essential because it provides definitive confirmation of the diagnosis and helps determine the cell type of the tumor. This information is critical for developing an appropriate treatment plan.

Treatment Strategies for Pancoast Tumors

The treatment of Pancoast tumors typically involves a multidisciplinary approach, combining various modalities to achieve the best possible outcome. The main treatment strategies include:

1. Chemotherapy

Chemotherapy plays a crucial role in the treatment of Pancoast tumors, often used in combination with other therapies. It may be administered:

• Before surgery (neoadjuvant chemotherapy) to shrink the tumor and improve surgical outcomes
• After surgery (adjuvant chemotherapy) to eliminate any remaining cancer cells
• As a primary treatment for tumors that cannot be surgically removed

2. Radiation Therapy

Radiation therapy is frequently used in the treatment of Pancoast tumors, either alone or in combination with other treatments. It may be employed:

• Before surgery to reduce tumor size
• After surgery to destroy any remaining cancer cells
• As a primary treatment for inoperable tumors
• For palliative care to alleviate symptoms in advanced cases

3. Surgery

Surgical intervention is often a key component of Pancoast tumor treatment. The specific surgical approach depends on the tumor’s size, location, and extent of invasion. Common surgical procedures include:

• Lobectomy: Removal of the affected lobe of the lung
• En bloc resection: Removal of the tumor along with affected surrounding structures (ribs, nerves, blood vessels)
• Video-assisted thoracoscopic surgery (VATS): A minimally invasive approach for suitable cases

How does the choice of surgical approach impact patient outcomes? The selection of the most appropriate surgical technique is crucial, as it can significantly affect the patient’s recovery, potential complications, and long-term prognosis. Factors such as tumor size, invasion of surrounding structures, and the patient’s overall health are considered when determining the best surgical approach.

Innovative Treatments and Clinical Trials for Pancoast Tumors

As medical research advances, new treatment options for Pancoast tumors are continually being explored. Some innovative approaches currently under investigation include:

1. Immunotherapy

Immunotherapy harnesses the power of the patient’s immune system to fight cancer cells. Various immunotherapy drugs are being studied for their efficacy in treating Pancoast tumors, either alone or in combination with other treatments.

2. Targeted Therapies

These treatments target specific genetic mutations or proteins that drive tumor growth. For Pancoast tumors with certain genetic alterations, targeted therapies may offer a more personalized treatment approach.

3. Proton Beam Therapy

This advanced form of radiation therapy uses protons instead of X-rays to deliver radiation to the tumor. It may offer more precise targeting of the tumor while minimizing damage to surrounding healthy tissues.

Are clinical trials available for patients with Pancoast tumors? Yes, numerous clinical trials are ongoing to evaluate new treatments and combinations of existing therapies for Pancoast tumors. Patients should discuss with their healthcare providers whether participating in a clinical trial might be appropriate for their specific case.

Prognosis and Long-term Outlook for Pancoast Tumor Patients

The prognosis for patients with Pancoast tumors has improved significantly in recent years, thanks to advancements in diagnostic techniques and treatment strategies. However, the outlook can vary widely depending on several factors:

• Stage of the tumor at diagnosis
• Extent of invasion into surrounding structures
• Presence of metastasis
• Patient’s overall health and ability to tolerate treatment
• Response to initial treatment

What is the five-year survival rate for Pancoast tumor patients? The five-year survival rate for Pancoast tumors varies depending on the stage at diagnosis and treatment approach. With modern multimodality treatment, some studies have reported five-year survival rates of 30-50% for patients with resectable tumors. However, these rates can be significantly lower for patients with more advanced disease or those unable to undergo surgery.

It’s important to note that survival statistics are based on historical data and may not reflect the most recent treatment advancements. Each patient’s case is unique, and individual outcomes can vary widely.

Living with a Pancoast Tumor: Supportive Care and Quality of Life

Managing a Pancoast tumor involves more than just treating the cancer itself. Supportive care plays a crucial role in maintaining quality of life and addressing the various challenges that patients may face. Key aspects of supportive care include:

1. Pain Management

Given the severe pain often associated with Pancoast tumors, effective pain management is essential. This may involve:

• Prescription pain medications, including opioids when necessary
• Nerve blocks or other interventional pain management techniques
• Complementary therapies such as acupuncture or massage

2. Psychological Support

Coping with a Pancoast tumor diagnosis and treatment can be emotionally challenging. Psychological support may include:

• Individual counseling or therapy
• Support groups for cancer patients
• Mindfulness and relaxation techniques

3. Rehabilitation

Physical and occupational therapy can help patients maintain function and independence, particularly if they experience weakness or mobility issues due to the tumor or its treatment.

4. Nutritional Support

Proper nutrition is crucial during cancer treatment. Patients may benefit from working with a registered dietitian to ensure they’re meeting their nutritional needs.

How can patients and caregivers access supportive care resources? Many cancer treatment centers have dedicated supportive care teams that can provide or coordinate these services. Additionally, organizations such as the American Cancer Society offer resources and support for cancer patients and their families.

Prevention and Early Detection of Pancoast Tumors

While it’s not always possible to prevent Pancoast tumors, there are steps individuals can take to reduce their risk and increase the chances of early detection:

Risk Reduction Strategies

• Quit smoking or never start
• Avoid secondhand smoke exposure
• Use appropriate protective equipment when working with hazardous materials like asbestos
• Maintain a healthy lifestyle with regular exercise and a balanced diet

Early Detection

Early detection of Pancoast tumors can be challenging due to their location and atypical symptoms. However, individuals at high risk for lung cancer may benefit from:

• Regular check-ups with a healthcare provider
• Lung cancer screening with low-dose CT scans for eligible high-risk individuals
• Prompt evaluation of persistent shoulder or arm pain, especially if accompanied by other suspicious symptoms

Can regular screening prevent Pancoast tumors? While screening cannot prevent the development of Pancoast tumors, it may help detect them at an earlier, more treatable stage. However, current lung cancer screening guidelines are not specific to Pancoast tumors and are generally recommended for individuals at high risk for lung cancer based on age and smoking history.

In conclusion, Pancoast tumors present unique challenges in diagnosis and treatment due to their location and behavior. However, with advancements in medical technology and treatment approaches, outcomes for patients with these rare tumors continue to improve. Early detection, comprehensive treatment strategies, and supportive care are key factors in managing Pancoast tumors and improving patient quality of life. As research progresses, new therapies and treatment combinations offer hope for even better outcomes in the future.

Pancoast Tumor

Written by WebMD Editorial Contributors

• Pancoast Tumor Causes
• Pancoast Tumor Symptoms
• Pancoast Tumor Exams and Tests
• Treatment for a Pancoast Tumor
• Medications for Pancoast Tumors
• Surgery for a Pancoast Tumor
• Preventing Pancoast Tumor
• Outlook for Pancoast Tumor
• More

Pancoast tumors form at the very top of either lung. They are usually non-small cell lung cancers. Because of their location, they frequently invade adjoining tissue.

Pancoast tumors form an abnormal patch of tissue over the lung apex and principally involve the chest wall structures rather than the underlying lung tissue. They may invade areas such as lymph nodes, nerves, ribs, and spine.

The risk factors for almost all lung cancers are similar. These include the following:

• Smoking
• Secondary smoke exposure
• Prolonged asbestos exposure
• Exposure to industrial elements (such as chromium or nickel)

Although a Pancoast tumor is a lung tumor, it rarely causes symptoms that are typically related to the lungs (like cough or chest pain).

The initial symptom is usually pain in the shoulder, the inner part of the shoulder blades, or both.

The pain may later extend to the inner side of the arm, the elbow, as well as the pinky and ring fingers.

The associated pain is severe and constant, often requiring narcotic pain medications for relief. The affected person usually needs to support the elbow of the affected arm in the opposite hand to ease the tension on the shoulder and upper arm.

The hand, arm, and forearm may weaken, muscles degenerate or shrink from disuse, or develop a sensation of pricking, tingling, or creeping on the skin.
 

If the tumor extends to the certain nerves, Horner syndrome may develop on one side of the face. Horner syndrome is characterized by a drooping eyelid, absence of sweating on the affected side of the face, and narrowing of the pupil.

In up to 25% of people with a Pancoast tumor, compression of the spinal cord and paralysis of the lower half of the body develop when the tumor extends into the opening between two vertebrae.

Exams and tests that may be used to diagnose a Pancoast tumor include:

• Chest X-ray
  • In the early stages, Pancoast tumors are difficult to detect on chest X-rays because the top of the lung is located in an area of the body that is difficult to visualize clearly on an X-ray. Shadows that lie over the lungs make the image on the X-ray film unclear. Many patients end up consulting orthopedic surgeons and/or neurologists before a definitive diagnosis is made.
  • A chest X-ray may reveal anything from asymmetry of the top of the lungs in the form of a small, uniform patch of tissue on the apex of one lung to a large mass, depending on the stage when the tumor is first diagnosed.
  • The plain chest X-ray may show that the tumor has invaded one or more ribs or parts of the vertebrae. Bone destruction of the back ribs may be visible on the X-ray.

• CT scan of the chest: A CT scan helps determine if the tumor has invaded areas such as the trachea (windpipe) or esophagus (food pipe). Contrast CT scanning, with the help of an injected, radioactive dye that is visible on the scan, is useful for assessing if the tumor has involved the blood vessels under the collarbone.
• MRI of the chest: MRI findings are more accurate than CT scans in identifying the extent of the tumor’s growth. An MRI can also better assess the tumor’s invasion of nearby areas.
• Arteriogram or venogram: For this test, a liquid is injected into nearby blood vessels so they will show up on an X-ray. Rarely, a Pancoast tumor involves the artery or the vein under the collarbone.
• Bronchoscopy (using a tubular, illuminated instrument for inspecting the airways of the lung) helps evaluate the tracheal and bronchial cavities. However, because most Pancoast tumors form on the periphery of the lung, bronchoscopy does not usually help the doctor make a diagnosis.
• Biopsy: This is the removal of a sample of tissue for examination under a microscope. Following a needle biopsy, the doctor can make a diagnosis in 95% of people with a Pancoast tumor based on results from the biopsy, either with the help of an X-ray or CT scan to help guide the doctor.
• Although more than 90% of patients can be correctly diagnosed based on clinical and radiological findings (chest X-ray, CT, MRI) alone, open biopsy of the tumor for confirmation may need to be performed through an incision above the collarbone. A definite diagnosis is important before proceeding with treatment of a Pancoast tumor. Results from a needle biopsy are also useful in determining the cell type prior to treatment. Even though getting a diagnosis is relatively simple, performing a tissue biopsy is almost always necessary.

Tests to Determine Spread

• Among other considerations, a CT or MRI scan of the brain is usually recommended in the initial evaluation, because distant spread to the brain is common, and diagnosis of these is necessary to determine treatment.
  Mediastinoscopy: This procedure is performed to determine the extent the tumor has spread into nearby areas. It is a procedure in which a tube is inserted behind the breastbone through a small cut at the lowest part of the neck. Samples of lymph nodes are taken from this area to look for cancer cells.
  Positron emission tomography (PET) scans (a nuclear imaging technique used to view body functions) may help identify involved lymph nodes and the distant spread of cancer.
• Bone scans may be used to see if the cancer has spread to the bones.

Medical management plays a large role in the treatment of Pancoast tumors. If the cancer has spread, medical treatment is required to reduce the symptoms without curing the underlying cause.

The standard of care for people with a Pancoast tumor is chemotherapy and radiation followed by removal of the tumor and a portion of the the chest wall if it is affected or if its removal facilitates surgery. The purpose of the chemotherapy and radiation is to shrink the tumor and to block the cancer from spreading through lymph nodes. An interval of two to four weeks after the chemo and radiation allows the procedures to reach their maximal effect. After four weeks, all patients are reassessed for surgery. If the cancer has not spread to distant areas of the body, surgery will likely be offered.

Prior to surgery, the doctor carefully assesses and stages the cancer. During surgery, the doctor usually removes a portion of the chest wall and part of the lung. The survival rate associated with this procedure is typically 30% to 50% after five years.

People with Pancoast tumors that are directly invading the covering of the lung and chest wall should generally undergo surgery, if:

• The cancer has not spread to distant parts of the body.
• The patient’s heart and lungs are healthy enough to allow surgery.
• There is no evidence of extensive enlargement of the lymph nodes.

The patient’s outlook is then dependent on the status of the lymph nodes. Occasionally, people with severe pain who have tumors that can’t be removed may be selectively considered for palliative surgery to reduce pain.

The most important preventive step is to avoid using tobacco products. Quitting tobacco also reduces the risk of lung cancer.

Taking precautions to reduce exposure to harmful substances in the environment (such as asbestos) can also reduce the risk of developing lung cancer.

In the past, Pancoast tumors were considered inoperable and incurable because of their relative inaccessibility and extensive invasion of nearby tissues and structures. However, recent studies have shown that, in some people, the tumor completely stops growing and the pain is gone. In addition, survival rates have improved.

Studies demonstrate that radiation and chemotherapy — before surgery — in doses strong enough to shrink the tumor:

• Decrease the chance that the tumor will grow back
• Prevent tumor cells from growing elsewhere in the body
• Increase the chance of survival compared with radiation, chemotherapy, or surgery alone

Top Picks

Pancoast Tumor

Written by WebMD Editorial Contributors

• Pancoast Tumor Causes
• Pancoast Tumor Symptoms
• Pancoast Tumor Exams and Tests
• Treatment for a Pancoast Tumor
• Medications for Pancoast Tumors
• Surgery for a Pancoast Tumor
• Preventing Pancoast Tumor
• Outlook for Pancoast Tumor
• More

Pancoast tumors form at the very top of either lung. They are usually non-small cell lung cancers. Because of their location, they frequently invade adjoining tissue.

Pancoast tumors form an abnormal patch of tissue over the lung apex and principally involve the chest wall structures rather than the underlying lung tissue. They may invade areas such as lymph nodes, nerves, ribs, and spine.

The risk factors for almost all lung cancers are similar. These include the following:

• Smoking
• Secondary smoke exposure
• Prolonged asbestos exposure
• Exposure to industrial elements (such as chromium or nickel)

Although a Pancoast tumor is a lung tumor, it rarely causes symptoms that are typically related to the lungs (like cough or chest pain).

The initial symptom is usually pain in the shoulder, the inner part of the shoulder blades, or both.

The pain may later extend to the inner side of the arm, the elbow, as well as the pinky and ring fingers.

The associated pain is severe and constant, often requiring narcotic pain medications for relief. The affected person usually needs to support the elbow of the affected arm in the opposite hand to ease the tension on the shoulder and upper arm.

The hand, arm, and forearm may weaken, muscles degenerate or shrink from disuse, or develop a sensation of pricking, tingling, or creeping on the skin.
 

If the tumor extends to the certain nerves, Horner syndrome may develop on one side of the face. Horner syndrome is characterized by a drooping eyelid, absence of sweating on the affected side of the face, and narrowing of the pupil.

In up to 25% of people with a Pancoast tumor, compression of the spinal cord and paralysis of the lower half of the body develop when the tumor extends into the opening between two vertebrae.

Exams and tests that may be used to diagnose a Pancoast tumor include:

• Chest X-ray
  • In the early stages, Pancoast tumors are difficult to detect on chest X-rays because the top of the lung is located in an area of the body that is difficult to visualize clearly on an X-ray. Shadows that lie over the lungs make the image on the X-ray film unclear. Many patients end up consulting orthopedic surgeons and/or neurologists before a definitive diagnosis is made.
  • A chest X-ray may reveal anything from asymmetry of the top of the lungs in the form of a small, uniform patch of tissue on the apex of one lung to a large mass, depending on the stage when the tumor is first diagnosed.
  • The plain chest X-ray may show that the tumor has invaded one or more ribs or parts of the vertebrae. Bone destruction of the back ribs may be visible on the X-ray.

• CT scan of the chest: A CT scan helps determine if the tumor has invaded areas such as the trachea (windpipe) or esophagus (food pipe). Contrast CT scanning, with the help of an injected, radioactive dye that is visible on the scan, is useful for assessing if the tumor has involved the blood vessels under the collarbone.
• MRI of the chest: MRI findings are more accurate than CT scans in identifying the extent of the tumor’s growth. An MRI can also better assess the tumor’s invasion of nearby areas.
• Arteriogram or venogram: For this test, a liquid is injected into nearby blood vessels so they will show up on an X-ray. Rarely, a Pancoast tumor involves the artery or the vein under the collarbone.
• Bronchoscopy (using a tubular, illuminated instrument for inspecting the airways of the lung) helps evaluate the tracheal and bronchial cavities. However, because most Pancoast tumors form on the periphery of the lung, bronchoscopy does not usually help the doctor make a diagnosis.
• Biopsy: This is the removal of a sample of tissue for examination under a microscope. Following a needle biopsy, the doctor can make a diagnosis in 95% of people with a Pancoast tumor based on results from the biopsy, either with the help of an X-ray or CT scan to help guide the doctor.
• Although more than 90% of patients can be correctly diagnosed based on clinical and radiological findings (chest X-ray, CT, MRI) alone, open biopsy of the tumor for confirmation may need to be performed through an incision above the collarbone. A definite diagnosis is important before proceeding with treatment of a Pancoast tumor. Results from a needle biopsy are also useful in determining the cell type prior to treatment. Even though getting a diagnosis is relatively simple, performing a tissue biopsy is almost always necessary.

Tests to Determine Spread

• Among other considerations, a CT or MRI scan of the brain is usually recommended in the initial evaluation, because distant spread to the brain is common, and diagnosis of these is necessary to determine treatment.
  Mediastinoscopy: This procedure is performed to determine the extent the tumor has spread into nearby areas. It is a procedure in which a tube is inserted behind the breastbone through a small cut at the lowest part of the neck. Samples of lymph nodes are taken from this area to look for cancer cells.
  Positron emission tomography (PET) scans (a nuclear imaging technique used to view body functions) may help identify involved lymph nodes and the distant spread of cancer.
• Bone scans may be used to see if the cancer has spread to the bones.

Medical management plays a large role in the treatment of Pancoast tumors. If the cancer has spread, medical treatment is required to reduce the symptoms without curing the underlying cause.

The standard of care for people with a Pancoast tumor is chemotherapy and radiation followed by removal of the tumor and a portion of the the chest wall if it is affected or if its removal facilitates surgery. The purpose of the chemotherapy and radiation is to shrink the tumor and to block the cancer from spreading through lymph nodes. An interval of two to four weeks after the chemo and radiation allows the procedures to reach their maximal effect. After four weeks, all patients are reassessed for surgery. If the cancer has not spread to distant areas of the body, surgery will likely be offered.

Prior to surgery, the doctor carefully assesses and stages the cancer. During surgery, the doctor usually removes a portion of the chest wall and part of the lung. The survival rate associated with this procedure is typically 30% to 50% after five years.

People with Pancoast tumors that are directly invading the covering of the lung and chest wall should generally undergo surgery, if:

• The cancer has not spread to distant parts of the body.
• The patient’s heart and lungs are healthy enough to allow surgery.
• There is no evidence of extensive enlargement of the lymph nodes.

The patient’s outlook is then dependent on the status of the lymph nodes. Occasionally, people with severe pain who have tumors that can’t be removed may be selectively considered for palliative surgery to reduce pain.

The most important preventive step is to avoid using tobacco products. Quitting tobacco also reduces the risk of lung cancer.

Taking precautions to reduce exposure to harmful substances in the environment (such as asbestos) can also reduce the risk of developing lung cancer.

In the past, Pancoast tumors were considered inoperable and incurable because of their relative inaccessibility and extensive invasion of nearby tissues and structures. However, recent studies have shown that, in some people, the tumor completely stops growing and the pain is gone. In addition, survival rates have improved.

Studies demonstrate that radiation and chemotherapy — before surgery — in doses strong enough to shrink the tumor:

• Decrease the chance that the tumor will grow back
• Prevent tumor cells from growing elsewhere in the body
• Increase the chance of survival compared with radiation, chemotherapy, or surgery alone

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Lung lobectomy in Moscow | Upper and lower

Lobectomy is a surgical operation to remove a lobe of the lung. Human lungs are anatomically divided into lobes – three on the right side and two on the left. These natural demarcations allow only one affected part to be removed while preserving the functioning of the rest of the organ.

In thoracic surgery, the following types of lobectomy are distinguished:

• upper lobectomy – removal of the upper part of the lung (also divided into right and left),
• middle lobectomy (right-sided) – removal of the middle lobe,
• lower lobectomy – removal of the lower affected lobe (also happens left-sided and right-sided),
• circular lobectomy – removal of a lobe of the lung, as well as part of the respiratory tract inside the affected organ,
• bilobectomy – removal of two lobes.

Our expert in this field:

Alexander Korotaev

Surgical oncologist, thoracic surgeon

Highest category
Work experience: 10 years

Contents

• 1) Indications for surgery
• 2) Contraindications
• 3) Lobectomy
• 4) Rehabilitation

Indications for surgery

Today, lobectomy is one of the most frequent operations in thoracic surgery. Removal of part of the lung is a more gentle option compared to the removal of the entire organ and makes it possible not only to improve the patient’s well-being, but also to improve his quality of life in the future.

Lung lobectomy is prescribed in the following cases:

1. Malignant oncological lung diseases with localization in one or two lobes.
2. Purulent and infectious diseases of the lungs – abscesses, bronchiectasis, etc.
3. Tuberculosis with the formation of caverns – in cases where conservative treatment is ineffective.
4. Malformations of the respiratory system.
5. Severe infections, incl. fungal.
6. Benign tumors and cysts.

Contraindications

Thoracoscopic lobectomy, despite a wide list of indications, has limitations in its implementation. Thus, removal of a lung lobe is not performed at stage 4 lung cancer and is rarely performed at stage 3, since in these cases only complete removal of the affected organ (pulmonectomy) can be effective.

Lobectomy is also not performed if the patient is in serious condition.

Before the operation, a thorough comprehensive examination is mandatory, which makes it possible to clarify the diagnosis and plan the intervention. The surgeon receives a detailed comprehensive picture of the patient’s condition and chooses the most optimal option that allows you to remove the affected lobe of the lung and preserve the functioning of the healthy part of the organ.

Computed tomography with contrast is usually the most informative examination method. It allows the doctor to determine the exact size and boundaries of the problem focus. An ultrasound is also performed to assess the condition of the lymph nodes. If a biopsy of the pathological tissue was performed before the lobectomy, then a histological examination is performed to accurately determine the structure of this tissue and the nature of the pathology.

The standard set of preliminary examinations also includes ECG and X-ray, urine and blood tests. Additional examination methods may be prescribed individually.

Lobectomy

Lobectomy is performed under general anesthesia. There are two options for its implementation – thoracoscopic (minimally invasive) and classic (open). The first option is more preferable from the point of view of safety for the patient and acceleration of rehabilitation. Instead of a large incision, the doctor makes three small ones, through which he inserts surgical instruments and a thoracoscope, a device with a miniature video camera on a flexible tube. The image from the camera in high resolution is transmitted to the monitor, which allows the doctor to clearly see the whole picture and perform manipulations as accurately as possible.

During the operation, the surgeon tightens the blood vessels of the affected part of the lung and then removes it. The rest of the organ is expanded with compressed oxygen. The doctor installs a temporary drainage into the pleural cavity, through which blood, excess fluid and air are drained. The drain is removed after a few days.

Rehabilitation

Recovery after lung lobectomy requires careful medical supervision. Immediately after the operation, the patient stays in the intensive care unit for some time. In some cases, a temporary connection to a ventilator may be necessary. As soon as the patient’s condition stabilizes, he is transferred to a regular ward.

After a few days the patient is allowed to eat while sitting and gradually get up. If the patient feels satisfactory, he is discharged after 5-7 days. Full rehabilitation usually takes 2-3 months. To speed up recovery, it is recommended to regularly perform breathing exercises. Also, a spa treatment can be a good help.

The condition after lobectomy largely depends on the individual characteristics of the patient – his age, general condition of the body, severity and duration of the disease. The amount of surgery is also important. So, after a thoracoscopic lobectomy, recovery is faster, since this type of intervention gives less stress on the body – the incisions in this type of operation are smaller, therefore, the healing process is faster.