Lobectomy

January 24, 2025

This page was reviewed under our medical and editorial policy by Jyoti Malhotra, M.D., M.P.H., associate professor, Department of Medical Oncology & Therapeutics Research, City of Hope^® Orange County Lennar Foundation Cancer Center; and Jae Y. Kim, M.D., associate professor, Division of Thoracic Surgery, Department of Surgery, City of Hope Cancer Center Duarte

Surgery may be considered as part of a treatment plan for certain types of lung cancer. When all, or part, of the lung is removed, it is known as a lung resection. In a lobectomy, a type of lung resection, an entire lobe containing a cancerous tumor is removed. It is often the preferred surgery for non-small cell lung cancer (NSCLC).

Other types of lung resections that may be performed with lung cancer include the following.

Pneumonectomy: This procedure removes the entire lung and is performed if the cancer is located near the middle of the chest.

Lung segmentectomy: This removes part of the lung lobe and may be performed if someone’s lung function is poor.

Sleeve resection: This removes part of an airway and may be performed to treat cancers in the airways.

Wedge resection: This removes a piece of lung (smaller than a segment)

This guide is designed to help patients learn more about lobectomy, including how it is used to treat cancer, what recovery may look like and how it compares to other lung cancer surgery options.

What Is a Lobectomy?

The lungs have five lobes. The left side of the lungs has two, while the right side has three lobes and is slightly larger.

As a treatment for lung cancer, a lobectomy removes the lobe that contains the tumor as well as some nearby lymph nodes to help lower the risk of cancer spreading. The procedure is sometimes referred to as lung lobectomy or pulmonary lobectomy.

If the patient’s lungs are healthy enough, lobectomy has long been the treatment of choice for NSCLC because it is linked with higher rates of survival. Lobectomy is considered the standard of care for tumors larger than 2 centimeters (cm). For peripheral tumors smaller than 2 cm, segmentectomy or wedge resection offer equivalent survival rates.

After a lobectomy, the doctor may also recommend chemotherapy or radiation therapy to destroy any cancer cells that may remain.

Lobectomy Surgery

Lung surgery is performed in one of two ways: through open surgery, called a thoracotomy, or through a minimally invasive procedure, which uses a smaller incision and specialized instruments. The tumor’s size and location help to determine what procedure the surgeon recommends.

Thoracotomy: A thoracotomy is often performed when a minimally invasive surgery is not possible, due to the cancer’s size and location. In this procedure, the surgeon makes an incision between the ribs, then spreads them open to see and operate on the lung lobe that needs to be removed. The incision could be anywhere from 1 to several inches in length. Every surgery is different, but a thoracotomy usually takes between three and six hours. Because the ribs are affected, activity is limited for at least one to two months after surgery. Pain and soreness are managed with medications and self care.

Minimally invasive surgery: Some patients are candidates for minimally invasive lung surgery, procedures in which the surgeon makes small incisions and uses cameras, computers and/or robots to operate. A lobectomy may be performed as a video-assisted thoracoscopic surgery (VATS) or a robotic-assisted thoracoscopic surgery (RATS). Both procedures may be faster than an open thoracotomy and have shorter recovery times. Minimally invasive surgeries are performed through one incision about 2 inches long for a chest tube and three to five smaller ones. The surgeon then uses a camera and computer screen or robotic assistance to visualize the area being operated on without having to spread the ribs apart manually. In addition to shorter recovery times, VATS and RATS have a lower risk of complications.

Procedure Recovery

A lobectomy is a major lung surgery. It is performed under general anesthesia, and most patients are hospitalized for at least two to three days after the operation. This is what patients typically may expect:

• At the hospital, they may have a chest tube to drain fluids and keep the lungs from deflating. It is usually removed one to two days after surgery. An incision where the tube was inserted will be covered by a gauze dressing.
• Patients typically are allowed to shower 24 hours after the chest tube has been removed.
• Narcotic pain medication may be given to ease discomfort, but patients are encouraged to wean off of it quickly. Once discharged from the hospital, they are reminded that driving is not allowed while taking narcotics.
• Patients are typically instructed not to lift anything more than 10 pounds until their follow-up appointment with the surgeon. Heavy lifting should also be avoided for about a month after surgery.
• Patients receive a spirometer, a small device with a plastic tube and a breathing attachment, and are taught how to use it. It is intended to help rebuild lung function, and using it frequently during recovery is important.

Long-term recovery from a lobectomy may take anywhere from a few weeks to several months. Patients who undergo a thoracotomy need a longer time to fully heal, usually at least one to two months. Those who have had a VATS or a RATS procedure typically recover more quickly.

Some patients may be able to resume normal activities once they heal, but this depends on their overall health and function of the remaining lung. People usually feel more fatigued in the weeks after surgery, but they are encouraged to set a daily goal of at least 30 minutes of physical activity to help strengthen the lungs.

As the patient heals, the body adjusts to compensate for the missing part of the lung. The remaining healthy lung tissue is able to expand to fill up the new space, and the other lung may even shift toward the missing lung.

Ongoing checkups with a physician and the cancer care team are also part of recovery.

Lobectomy Complications

As a major surgery, lobectomy does pose some potential risks, which may include:

• Excessive bleeding
• Pain
• Muscle soreness, especially in the upper body
• Blood clots in the lungs and/or legs
• Infections in the wound sites and lungs
• Reaction to anesthesia
• Itching or discomfort from incisions
• Collapsed lung (air leaks from the lung into the chest cavity)
• Depression and mood swings
• Problems sleeping
• Constipation

In rare cases, a patient may not survive the surgery.

Sleeve Lobectomy Versus Lobectomy

Another surgical treatment option for early lung cancer is a sleeve lobectomy. A sleeve lobectomy — sometimes called a pulmonary sleeve resection — removes a small part of the lobe, as well as a part of the airway, instead of removing an entire lung lobe. The remaining airway is then reattached to the remaining lobe portions.

A sleeve lobectomy may preserve more of the lung and may be appropriate when the cancer has affected the airway.