mickey61
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Posts:26
Vats, lobectomy, wedge or sleeve, what would be the option if your lung functions were not good and the lesion is 1.3cm. What is the reasoning behind not doing a wedge or sleeve and removing a whole lobe? Also anterior right upper lung, the right lung has three lobes is there any better then some places for a nodule to be. Your opinion.
Thanks Mickey
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Reply # - February 5, 2013, 04:13 PM
Reply To: Lobectomy, wedge, sleeve?
mickey, I think it will be helpful for you to read what our library has to offer in the way of lung surgeries. The link below is a good starting point and there are several links incorporated in the post as well as after the post.
I hope this helps,
Janine
http://cancergrace.org/lung/2010/12/14/revisiting-the-optimal-early-sta…
Reply # - February 5, 2013, 05:40 PM
Reply To: Lobectomy, wedge, sleeve?
Hi Mickey:
As Janine pointed out, there is a wealth of information here on GRACE. . .and a lot of different factors related to individual patients go into what particular type of surgery is suitable. I can tell you that you can have a lobectomy or wedge resection via VATS surgery - - so these things are not necessarily mutually exclusive. I believe that a sleeve or a bag also is used in a VATS lobectomy or wedge resection situaltion. So, again, not necessarily mutually exclusive.I also can tell you that some patients can have a pneumonectomy (i.e., the removal of an entire lung) via what is know as a mini-thoracotomy (so they don't open your chest the way they do with a traditional thoracotomy - - the incision is much smaller, recovery is much easier, etc.). In fact, my Mom's surgery at first was scheduled to be a VATS lobectomy, but then there was a matted cancerous lymph node on the main right bronchus. So, midway through the surgery it turned into a mini-thracotomy and they took her entire right lung.
Anyway, happy reading. . .and please ask any follow-up questions that you may have once you've perused the site.
Laya
Reply # - February 5, 2013, 07:28 PM
Reply To: Lobectomy, wedge, sleeve?
For lung cancers smaller than 2 cm, the potential value of a smaller surgery is certainly an open and debatable question. There is actually a randomized trial being done now to compare a wedge resection or segmentectomy to a lobectomy in patients with a solitary and clinically node-negative cancer smaller than 2 cm, but I can also tell you that many thoughtful lung cancer surgeons are more comfortable enrolling patients with a nodule smaller 1 cm or smaller, favoring a lobectomy for a nodule in the 1-2 cm range. The current standard of care in the US for patients who can tolerate a lobectomy safely is currently a lobectomy, which has the highest cure rates, though there are definitely individual circumstances that might lead a good surgeon to favor a wedge resection or segmentectomy.
In addition to the size of the lesion, its location and a patient's lung function are also very important in making these kinds of recommendations.
The right middle lobe is smaller than the others and would be the easiest one to sacrifice, but of course nobody can pick which area of the lung their cancer appears in.
-Dr. West