Lung Wedge Resection

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

Lung wedge resection is a surgery used to treat certain lung cancers by removing a small, wedge-shaped piece of lung tissue containing the tumor. It is one of several surgical options for lung tumors.

Other procedures include pneumonectomy (removing an entire lung), lobectomy (taking out a whole lobe of the lung) and sleeve resection (removing part of a large airway). Each aims to eliminate cancerous tissue while preserving as much healthy lung tissue as possible.

What Is a Lung Wedge Resection?

During a lung wedge resection, a small, triangle-shaped piece of lung tissue is removed. This piece includes the tumor and a margin of healthy tissue around it. The main goal is to remove the tumor while preserving as much lung function as possible. It is often considered for patients with early-stage non-small cell lung cancer or other localized lung diseases.

Some reasons providers might recommend a wedge resection instead of a lobectomy include addressing small peripheral tumors, or treating patients with limited lung capacity or other health conditions that make more extensive surgery risky. By removing only one or more of the lung’s 10 segments, a wedge resection spares more healthy lung tissue.

Despite the concern of recurrence, interest in less invasive surgeries continues to grow as surgical technology improves. Advancements in surgical techniques now allow wedge resections to be performed using minimally invasive methods that use small incisions, such as video-assisted thoracoscopic surgery (VATS) or robotic-assisted surgery.

These approaches may reduce recovery time and lower the risk of complications.

Lung Wedge Resection Surgery

The two main surgical methods for wedge resection surgery are thoracotomy and VATS. Both are performed under general anesthesia, so the patient is asleep the entire time.

In a thoracotomy, which is an open surgery, the patient lies on his or her side with one arm positioned above the head. The surgeon makes an incision between two ribs on the side of the chest, sometimes extending from the front to the back, just under the armpit.

The lung on that side is deflated to prevent air from moving in and out during the operation, making it easier for the surgeon to work. The surgeon assesses the lung and decides how much tissue needs to be removed.

Afterward, the surgeon places one or more chest tubes to drain fluids that may accumulate. The ribs, muscles and skin are then closed with stitches. This procedure may take anywhere from two to six hours.

VATS is a minimally invasive alternative that may lead to less pain and a faster recovery. For this method, the surgeon makes several small incisions in the chest wall. A tiny camera, called a videoscope, and specialized surgical tools are inserted through these openings.

The videoscope transmits images to a monitor, guiding the surgeon as he or she removes the tumor and surrounding tissue. Chest tubes are also placed after a VATS to help drain fluids.

Procedure Recovery

After the wedge resection, patients typically spend some time recovering in the hospital. For an open thoracotomy, the hospital stay usually lasts about five to seven days, while a VATS procedure often allows for a shorter stay, often spanning just one night in the hospital. Some patients may spend time in the intensive care unit (ICU) immediately following the procedure.

During recovery, the medical team encourages patients to sit up and start walking as soon as possible to promote healing. Patients wear special compression stockings to prevent blood clots and may receive injections for the same purpose.

Pain management is an important aspect of recovery. Patients receive medication either through an intravenous (IV) line or by mouth. An epidural catheter (a thin tube inserted in the spine to give medicine) might also be used to deliver pain relief directly to the surgical area.

The patient is taught breathing exercises to prevent pneumonia and help the treated lung re-expand. Physical, occupational and respiratory therapists may also work with patients to strengthen their bodies and improve recovery outcomes.

Lung Function After Wedge Resection

After a wedge resection, most patients with otherwise healthy lungs may be able to return to normal activities after recovery, even though a small portion of lung tissue has been removed. Since this procedure removes less lung tissue than a lobectomy or pneumonectomy, it may result in better long-term lung function.

However, patients who have other lung conditions, like emphysema or chronic bronchitis — common among heavy smokers — might experience shortness of breath during physical activities after surgery and recovery.

Complications

Although less tissue is removed during a wedge resection than some other types of lung cancer surgery, it is still a serious medical procedure and complications and side effects are possible.

Complications that may happen within the first 30 days after surgery include:

• Fluid buildup in the lungs that makes breathing difficult
• Lung infection (pneumonia)
• Severe breathing difficulty (acute respiratory distress syndrome)
• Airway leaks
• Twisting of lung tissue
• Bleeding into the chest cavity (hemothorax)
• Leakage of lymph fluid into the chest (chylothorax)

Complications that may happen later in recovery may include:

• Narrowing of the airways (bronchial stenosis)
• Accumulation of pus in the chest cavity (empyema)
• Changes in chest anatomy (postpneumonectomy syndrome)
• Blood clots at the surgery site
• Abnormal connection between the esophagus and chest cavity

Lung Wedge Resection Versus Lobectomy

Lobectomy and wedge resection are two surgical options for treating lung cancer, differing in how much lung tissue is removed.

A lobectomy involves removing an entire lobe of the lung. This procedure is often considered the standard treatment for early-stage non-small cell lung cancer because it has been shown to reduce the risk of cancer recurrence.

A wedge resection is a type of lung-sparing surgery in which only a small piece of lung tissue containing the tumor is removed, not the entire lobe. This option is less invasive and preserves more lung tissue, which is believed to maintain better lung function.

Lung-sparing surgeries like wedge resection may be appropriate for patients with smaller, early-stage tumors detected through advanced imaging technologies. They also carry a lower risk of severe complications and may offer more treatment options if a second lung cancer develops later.

The choice between a lobectomy and a wedge resection depends on several factors, including the size and location of the tumor, the patient’s overall health and the potential risks and benefits of each procedure.