Pulmonary resection is a surgical procedure where part or all of a lung is removed to treat diseases such as cancer, severe infections, or other lung conditions. While it represents a major operation, advances in surgical techniques and post-operative care have made recovery increasingly manageable for many patients.

What is Pulmonary Resection?

Pulmonary resection, also called lung resection, is a type of surgery performed to remove diseased or damaged lung tissue. The human body has two lungs, each divided into sections called lobes—the right lung has three lobes and the left lung has two. Depending on the extent of the disease, surgeons may remove a small wedge of tissue, one or more lobes, or in some cases, an entire lung. Despite this being major surgery, many people can live healthy lives with reduced lung capacity or even with just one lung^[1].

The procedure is primarily used to treat lung cancer in its early stages, but it also addresses other serious conditions. Healthcare providers may recommend pulmonary resection for patients with infections that haven’t responded to other treatments, tuberculosis, lung abscesses, benign tumors, or chronic lung diseases like emphysema and bronchiectasis. In some situations, the surgery is performed to obtain tissue samples for diagnostic purposes rather than for treatment alone^[1][4].

Types of Pulmonary Resection

Several different types of pulmonary resection exist, each removing varying amounts of lung tissue depending on the patient’s specific medical needs. The most common type is called a lobectomy, where surgeons remove one entire lobe of the lung. This is frequently the standard approach for treating early-stage lung cancer because it removes the cancerous tissue while preserving as much healthy lung function as possible^[1][12].

A wedge resection is a more limited procedure where only a small, wedge-shaped section of lung tissue is removed. This type removes less lung tissue than a lobectomy and is often used for removing small, non-cancerous lesions or for diagnostic biopsies. A segmentectomy involves removing one to four segments of a lobe while leaving the rest intact, offering a middle ground between wedge resection and full lobectomy^[1][12].

In more extensive cases, surgeons may perform a bilobectomy, removing two lobes from the right lung, or a pneumonectomy, where an entire lung is removed. Pneumonectomy is typically reserved for cases where cancer or disease affects a large portion of one lung. There is also a specialized procedure called sleeve resection, where surgeons remove part of the lung and the main airway (bronchus), then reconnect the healthy airway to the remaining lung tissue. This technique helps preserve more lung function compared to pneumonectomy^[1][9].

Surgical Approaches

Pulmonary resection can be performed using different surgical approaches, each with its own advantages. Traditional open surgery, also called a thoracotomy, involves making a large incision in the side of the chest between the ribs. The surgeon then spreads the ribs apart to access the lung. While effective, this approach typically involves more pain and a longer recovery period^[1][12].

Minimally invasive techniques have become increasingly popular in recent years. Video-assisted thoracoscopic surgery (VATS) uses small incisions, typically two to three inches long, through which the surgeon inserts a camera and specialized instruments. The camera sends images to a screen, allowing the surgeon to see inside the chest without making a large opening. Some medical centers also use robotic-assisted versions of this technique. These minimally invasive approaches generally result in less pain, smaller scars, shorter hospital stays, and faster recovery times compared to open surgery^[1][5][12].

Conditions Treated by Pulmonary Resection

The most common reason for performing pulmonary resection is to treat lung cancer, particularly in stages I, II, and sometimes stage III. When lung cancer is caught early and hasn’t spread extensively, surgical removal offers the best chance for a cure in medically fit patients. The procedure is typically recommended for non-small cell lung cancer, which accounts for the majority of lung cancer cases^[1][4].

Beyond cancer, pulmonary resection treats a variety of other serious lung conditions. Patients with severe bronchiectasis—a condition where the airways become permanently widened and damaged—may benefit from having diseased portions of lung removed. The surgery can also address persistent lung infections, including tuberculosis that hasn’t responded to medication, as well as lung abscesses where pockets of infection form within lung tissue^[1][12].

In cases of severe emphysema, a specialized type of pulmonary resection called lung volume reduction surgery removes areas of damaged lung tissue that contain trapped air. This can help the remaining, healthier parts of the lung function more efficiently. Doctors also perform pulmonary resection to remove benign lung tumors or nodules, to treat injuries from trauma, and sometimes to diagnose lung conditions by obtaining tissue samples for analysis^[1][4].

Preparing for Surgery

Before undergoing pulmonary resection, patients typically need several preparatory steps to ensure the surgery proceeds safely. Your healthcare provider will give specific instructions tailored to your situation. Generally, patients must avoid eating or drinking for a certain period before the procedure, often starting at midnight the night before surgery. If you take regular medications, your doctor will tell you which ones to continue and which to temporarily stop^[1][7].

If you smoke, quitting before surgery is extremely important. Smoking affects healing and increases the risk of complications after lung surgery. Your medical team will strongly encourage you to stop smoking as far in advance of the procedure as possible. You’ll also need to arrange for several days in the hospital after surgery and for someone to drive you home when you’re discharged^[1][18].

Doctors typically order several tests before surgery to assess your lung function and overall health. These may include blood tests, chest X-rays, CT scans, MRI scans, or specialized breathing tests called pulmonary function tests. Some patients may also need a tissue biopsy, bronchoscopy (where a camera is inserted into the airways), or PET scans to help determine the extent of disease and plan the surgery^[1][12].

The Surgical Procedure

During pulmonary resection, patients receive general anesthesia, meaning they are completely unconscious throughout the operation. A breathing tube is placed in the throat to help maintain breathing during surgery. The procedure typically takes anywhere from two to six hours, depending on the complexity of the surgery and the amount of lung tissue being removed^[4][12].

The surgeon makes incisions based on the chosen surgical approach—either one larger incision for open surgery or several smaller ones for minimally invasive surgery. Once inside the chest cavity, the surgeon carefully identifies and removes the diseased lung tissue. This often involves sealing off blood vessels and airways that supply the affected portion of lung. In some cases, nearby lymph nodes are also removed for examination. After removing the necessary tissue, the surgeon closes the incisions with stitches or staples^[2][4].

Before closing the chest, surgeons typically place one or more drainage tubes through the chest wall. These tubes help drain excess fluid and air from the chest cavity during the initial recovery period, allowing the remaining lung tissue to properly re-expand. The drainage tubes usually stay in place for about a week after surgery^[8][18].

Recovery and Post-Operative Care

Recovery from pulmonary resection is a gradual process that requires patience and careful attention to your body’s signals. Most patients spend three to seven days in the hospital immediately after surgery, though this varies based on individual circumstances and the type of procedure performed. During this time, medical staff closely monitor your condition, help manage pain, and assist with early mobility^[7][19].

It’s completely normal to feel tired for six to eight weeks after surgery. Your chest will likely be sore and swollen for up to six weeks, and you may experience stiffness, aching, or sensations of tightness, itching, numbness, or tingling around the incision site for up to three months. Many patients also experience shortness of breath initially as their body adjusts to having less lung capacity. Healthcare providers will teach you special breathing and coughing exercises to help your lungs get as much oxygen as possible and prevent complications like pneumonia^[8][18].

Pain management is an essential part of recovery. Your doctor will prescribe pain medications to help you stay comfortable. It’s important to take these medications as directed, not just when pain becomes severe. Keeping pain under control helps you breathe more deeply, cough effectively, and move around more easily—all important for preventing complications^[8][19].

Physical activity should be gradually increased during recovery. While you should rest when tired, it’s also important to walk a little bit each day, slowly increasing the distance. Walking helps prevent blood clots, pneumonia, and constipation. However, you’ll need to avoid strenuous activities like heavy lifting (anything over about 4.5 pounds), jogging, swimming, or activities that strain your arm and shoulder muscles for six to eight weeks or until your doctor approves. Most people need to take one to two months off from work, depending on the type of work they do and how they feel^[8][18].

Potential Risks and Complications

Like all major surgeries, pulmonary resection carries certain risks, though serious complications are relatively uncommon. The most frequent post-operative complications include pneumonia, which occurs when infection develops in the remaining lung tissue, and atelectasis, where portions of the lung collapse or don’t inflate properly. These respiratory complications affect roughly 10% of patients undergoing lung resection and are more likely in patients who already have reduced lung function^[14].

Other potential complications include air leaks from the remaining lung tissue, where air escapes into the chest cavity rather than being expelled normally during breathing. Some patients develop fluid buildup in the chest that requires drainage, or in rare cases, an empyema—a collection of infected fluid in the chest cavity. Bleeding, blood clots, and injury to surrounding structures like blood vessels can also occur but are less common^[4][7].

Studies have shown that patients who develop post-operative pulmonary complications tend to have longer hospital stays, require more intensive care, and face higher mortality rates in the weeks and months following surgery. This underscores the importance of careful patient selection, proper surgical technique, and attentive post-operative care. However, when complications are recognized and treated early, most patients still achieve good outcomes^[14].

Long-Term Outlook

For most people, the long-term outlook after pulmonary resection is positive, particularly when the surgery successfully treats the underlying condition. It typically takes six to twelve months to fully regain lung function and adjust to life with reduced lung capacity. The extent of recovery depends on several factors, including how much lung tissue was removed, the patient’s overall health before surgery, and whether the underlying condition (such as cancer) has been fully addressed^[5][19].

Research comparing pulmonary resection techniques has shown some important findings. Studies indicate that for patients with early-stage lung cancer, procedures that preserve more lung tissue—such as sleeve resection instead of pneumonectomy—often result in better survival rates and improved quality of life. This has led many surgeons to favor lung-sparing techniques whenever medically appropriate, even in patients who could theoretically tolerate more extensive surgery^[9].

After recovery, many patients return to their normal daily activities, though some adjustments may be necessary. Regular follow-up care is essential, especially for cancer patients who may need additional treatments like chemotherapy or radiation therapy. Your healthcare team will monitor your breathing, watch for signs of disease recurrence, and help you maintain the best possible lung function with appropriate exercises and lifestyle modifications^[19][22].