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About Surgery - What to Expect & Things to Know

Therapeutic Procedures
video-assisted thoracic surgery (VATS) • thoracoscopy • thoracotomy • chest tube thoracostomy

Palliative Procedures
laser therapy • stents • photodynamic therapy

Things to Know Before Surgery
questions to ask • anesthesia • determining operability • nutrition & surgery • surgical complications

Therapeutic Procedures

Surgery for Lung Cancer (CancerHelp UK)
Briefly describes the three types of operations used to treat NSCLC:
*removing a lung section (wedge resection, segmentectomy)
*removing a lobe of the lung (1-lobectomy, 2-bilobectomy)
*removing the whole lung (pneumonectomy)
Aimed at patients. [1/04]

Pneumonectomy (InteliHealth)
Describes pneumonectomy, what it is, why it is performed, how it is done and possible risks to the procedure. Preparation and follow-up care are also discussed. Registration required for free access to Intelihealth. [4/04]

Video-Assisted Thoracic Surgery (VATS)

Minimally Invasive Surgery: Video-Assisted Lung and Chest Surgery (VATS) (University of Pennsylvania Medical Center)
Discusses a surgical technique known as video-assisted thoracic surgery (VATS) which enables surgeons to perform many common thoracic procedures in a minimally invasive manner. Describes VATS, the diseases that can be treated with VATS, who may be a candidate for VATS, the advantages of VATS and what to expect after VATS surgery.

Video-Assisted Thoracic Surgery (Harvard Family Health Guide)
Describes video-assisted thoracic surgery (VATS): what it is, how it is performed and what to expect.

The Role of Video-Assisted Thoracic Surgery (VATS) in the Management of Lung Cancer (
Discusses the role of VATS in lung cancer management: its advantages and its use for diagnosing pulmonary nodules, diagnosing and managing malignant pleural effusions, staging of lymph nodes, and performing lobectomy. Aimed at physicians. [undated]


Thoracoscopy (
Describes thoracoscopy, what it is used for, precautions, preparation, risks and possible results. [2001]


Thoracotomy (
Describes thoracotomy, a surgical procedure for opening the chest to remove a cancer of the lung. Basic chest anatomy and physiology is presented, along with a brief discussion of the causes, symptoms, diagnosis and treatment of lung cancer. Various lung surgeries are outlined.


Chest Tube Thoracostomy (Critical Care Assembly of the American Society)
Describes chest tube thoracostomy, a procedure performed to drain fluid, blood or air from the space around the lungs (pleural space). Lists common reasons for its use, including pleural effusion and pneumothorax. Covers risks and benefits of the procedure.

Palliative Procedures

Treatment for Advanced Lung Cancer: Laser Treatment and Airway Stents (CancerHelp UK)
Briefly describes laser treatment and airway stents, procedures used for relieving breathlessness caused by a blocked airway secondary to lung cancer. Aimed at patients. [1/02]

Endobronchial Management of Advanced Lung Cancer (Medscape)
by Michael Simoff
8(4) Cancer Control (2001):337-343
Reviews the use of several endobronchial treatment modalities, including
rigid and flexible bronchoscopy, laser therapy, endobronchial prosthesis, and photodynamic therapy. Recommends that these modalities be used to supplement traditional therapies for advanced lung cancer to provide symptom palliation and improved quality of life. Aimed at physicians. Registration required for free access to Medscape. [2001]

PDT Improves QOL in Lung Cancer Patients Who Have Endobronchial Obstruction (
v. 7, no. 7 Oncology News (July 1998)
Reports on two studies that found PDT a simple and effective alternative to standard techniques for palliative debridement of endobronchial obstructions in lung cancer patients.

Things to Know Before Surgery

Questions to Ask

Be Informed: Questions to Ask Your Doctor Before You Have Surgery (Agency for Health Care Policy and Research)
Twelve questions to ask your doctor before you have surgery, and the reasons for asking them. Lists sources for further information.[1/95]

Pneumonectomy: Can I Return to Normal Activities After Having a Lung Removed? (Mayo Clinic)
Describes the impact of lung removal on breathing and normal activities. Suggests ways to improve lung function following pneumonectomy. [3/03]


What You Should Know About Herbal Use and Anesthesia (American Society of Anesthesiologists)
Discusses the issue of herbal medicines and safety. Addresses the following questions: does the federal government make sure that herbs are safe? do I need to tell my doctor about the herbal products and other supplements that I take? could herbal medicines affect my anesthesia if I need surgery? [2/03]

Anesthesia and You (American Society of Anesthesiologists)
Provides an introduction to anesthesia and the role of the anesthesiologist. Covers the nervous system, the conquest of pain, anesthesia for same day surgery, and offers answers to frequently asked questions about anesthesia.

Determining Operability

Physiologic Evaluation of Patients with Lung Cancer Being Considered for Resectional Surgery (CHEST)
Abstract of the evidence-based lung cancer treatment guideline published by the American College of Chest Physicians (ACCP) in the supplement to the January 2003 issue of CHEST. Stresses that the preoperative physiologic assessment of a patient being considered for surgical resection of lung cancer must consider the immediate perioperative risks from comorbid cardiopulmonary disease, the long-term risks of pulmonary disability, and the threat to survival due to inadequately treated lung cancer. Discusses specific tests and desired results for consideration in determining surgical candidacy. Examines the possibility of combining lung volume reduction surgery (LVRS) and resection of lung cancer for patients with severe emphysema. Additional recommendations and assessments are included. Aimed at physicians. [1/03]

Impact of Cardiovascular Co-morbidity on the Outcome of Surgery (PubMed)
Study reported in the May 2003 issue of European Journal of Cardiothoracic Surgery that assessed the impact of coexisting cardiovascular disease on the outcome of surgical treatment of stage I and II NSCLC. Concluded that cardiovascular disease has a significant impact on survival and morbidity in patients undergoing surgery for lung cancer, especially those patients with multifocal vascular disease and following major resections. Recommends that the timing of vascular surgery and the extension of resection should rely on the severity of vascular disease, anesthesiologist's and surgeon's final evaluation. [5/03]

Nutrition & Surgery

Influence of Nutritional Status on Complications After Operations for Lung Cancer (Annals of Thoracic Surgery)
Abstract of a study examining the role of nutritional status in patients undergoing an operation for lung cancer. Results indicate that impaired nutrition is an important predictor of death and the need for reventilation after an operation for lung cancer. Suggests that the selection of patients for lung resection might be improved by measuring simple nutritional indices. [3/00]

Nutrition in Cancer Care: Effect of Surgery on Nutrition (
Discusses the effects of surgery on nutrition: surgery increases the body's need for nutrients and energy, nutrition-related side effects may occur as a result of surgery (eg, loss of appetite), and nutrition therapy can treat the nutrition-related side effects of surgery. [6/03]

Surgical Complications

Surgical Complications Information (Lung Cancer Online)


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Last modified: 18-Feb-2009
Karen Parles, MLS Editor