Our Summary

This research paper discusses a new method of surgery for patients with advanced lung cancer, aimed at avoiding a procedure called pneumonectomy, which involves removing the entire lung. Instead, a ’triple-plasty’ operation is performed, which involves the bronchus, pulmonary artery, and pulmonary vein. This procedure is sometimes referred to as ‘auto-lung transplantation’. The operation can be performed in two ways: ’transposition’, which is performed while the patient is alive, or ‘bench surgery’, which is performed outside of the body. One of the challenges of this procedure is to protect the lung from damage due to lack of blood supply and subsequent restoration of blood supply. To prevent this, the removed lung is washed with a special solution to preserve it. The paper suggests that removing the lung is easier with the bench surgery approach compared to traditional methods, and it does not increase the surgery time. The authors conclude by stating that this new method of surgery for lung cancer is a challenging but promising approach that needs to be further evaluated in the future.

FAQs

  1. What is the purpose of performing bronchovasculoplasty in patients with locally advanced lung cancer?
  2. What is the difference between the “transposition” and “bench surgery” procedures in auto-lung transplantation?
  3. What is the role of lung preservation solution in the process of excising the lung graft?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lung surgery is to follow all pre-operative instructions closely, such as fasting before the procedure and taking any prescribed medications as directed. It is also important to inform the medical team of any allergies or medical conditions prior to surgery. After surgery, it is important to follow the post-operative care plan provided by the medical team, which may include breathing exercises, pain management, and avoiding smoking or exposure to secondhand smoke. Additionally, attending follow-up appointments and communicating any concerns or changes in symptoms to the medical team is crucial for a successful recovery.

Suitable For

Patients who are typically recommended for lung surgery include those with locally advanced lung cancer who may benefit from extended resection to preserve lung parenchyma, as well as those with other lung conditions such as lung nodules, lung infections, or lung diseases such as emphysema. Additionally, patients with severe symptoms such as shortness of breath, persistent cough, or chest pain that cannot be managed with other treatments may also be candidates for lung surgery.

Timeline

  • Before lung surgery:
  1. Patient may undergo various tests such as chest X-rays, CT scans, and pulmonary function tests to determine the extent of the lung cancer and the feasibility of surgery.
  2. Patient may meet with a multidisciplinary team including surgeons, oncologists, and respiratory therapists to discuss the surgical options and potential risks.
  3. Patient may receive preoperative counseling and instructions on how to prepare for surgery, including fasting before the procedure and stopping certain medications.
  4. Patient may be admitted to the hospital the day before or the day of surgery for preoperative preparations.
  • During lung surgery:
  1. Patient will be placed under general anesthesia and a breathing tube may be inserted to assist with ventilation.
  2. Surgeon will perform the necessary procedure, which may involve removing part or all of the affected lung tissue.
  3. Surgery may take several hours depending on the complexity of the procedure.
  4. Patient will be closely monitored by the medical team during and after surgery to ensure stability and proper recovery.
  • After lung surgery:
  1. Patient will be moved to the recovery room or intensive care unit for monitoring and pain management.
  2. Patient may experience some pain, discomfort, and difficulty breathing in the immediate postoperative period.
  3. Patient will gradually be weaned off the ventilator and encouraged to start moving and deep breathing exercises to prevent complications such as pneumonia.
  4. Patient will be discharged from the hospital once stable and able to care for themselves at home.
  5. Patient will have follow-up appointments with the surgical team to monitor recovery, manage any complications, and discuss further treatment options such as chemotherapy or radiation therapy.

What to Ask Your Doctor

  1. What specific type of lung surgery do you recommend for my condition?
  2. What are the potential risks and complications associated with this type of lung surgery?
  3. How long is the recovery process expected to be after the surgery?
  4. Will I need any follow-up treatments or therapies after the surgery?
  5. What is the success rate for this type of lung surgery in patients with my condition?
  6. How experienced are you in performing this type of lung surgery?
  7. Will I need to make any lifestyle changes or modifications after the surgery?
  8. What are the alternatives to lung surgery for my condition?
  9. How long will I need to stay in the hospital after the surgery?
  10. Are there any specific instructions or precautions I should follow before and after the surgery?

Reference

Authors: Chida M. Journal: Nihon Geka Gakkai Zasshi. 2016 Jul;117(4):296-300. PMID: 30160841