Lung lobectomy is the removal of a lung lobe. The most common reason for removal of a lung lobe is for the treatment of a primary lung tumor. A primary lung tumor is one that originates in a single lung. If a primary lung tumor has metastasized to other lung lobes, removal of the primary tumor will be of little benefit. Other reasons for lung lobe removal include the presence of a lung abscess, lung lobe torsion (that is, twisting of the lung lobe around its vascular pedicle) and spontaneous pneumothorax.
Depending upon which lung lobe must be removed and the reason for the removal, the surgical approach can be made through the side of the chest between the ribs (intercostal thoracotomy) or through the breast bone (median sternotomy). The vascular pedicle is isolated, clamped and then occluded with a surgical stapling device that places 2-3 staggered rows of very small stainless steel staples across the pedicle and the lung lobe is then cut along its base and removed. The thoracic cavity is then surgically closed after the placement of a thoracostomy tube. The purpose of the thoracostomy tube is to remove air from within the thoracic cavity after closure of the surgical approach. Once the air is removed, the thoracostomy tube can be removed. Depending upon the case, it might be recommended to leave the thoracostomy tube in place for a variable amount of time following the surgery.
Post-operatively these patients must be activity limited to brief leash walks for urination and defecation for 4-6 weeks in an effort to allow the chest wall or sternum to heal appropriately. Spending the night in one of the 24-hour care facilities is generally recommended. Analgesic and antimicrobial medications will be prescribed. Approximately 10-14 days following surgery these patients should be returned to their veterinarian to assess progress and remove skin sutures or skin staples.
The short and long-term prognoses following lung lobectomy vary considerably depending upon why the lung lobe is being removed and on completeness of excision of the diseased tissue. Dr. Priddy will discuss in detail what you can expect from your pet following lung lobectomy.