Pneumonectomy

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A pneumonectomy (or pneumectomy) is an surgical procedure to remove all or part of a lung. Removal of just one lobe of the lung is specifically referred to as a lobectomy, and that of a segment of the lung as a segmentectomy.

The most common cause for a pneumonectomy is to excise tumourous tissue arising from lung cancer. Other indications for lobectomy include solitary pulmonary nodule (the possibility of undiagnosed small cell cancer in this instance is not necessarily a reason for avoiding thoracotomy), bronchiectasis where other forms of trearment have failed, particularly if it is localised and recurrent hemoptysis is present. In the days prior to AKT, tuberculosis was sometimes treated surgically by pneumonectomy.

It is clear that the operation will reduce the respiratory capacity of the patient; before conducting a pneumonectomy, the surgeon will evaluate the ability of the patient to function after the lung tissue is removed. After the operation, patients are often given an incentive spirometer to help exercise their remaining lung and to improve breathing function.

A rib or two is sometimes removed to allow the surgeon better access to the lung.

There are two types of pneumonectomy:

Simple pneumonectomy: Removal of just the affected lung
Extrapleural pneumonectomy: Removal of the affected lung, plus part of the diaphragm and the pericardium (lining of the heart) on that side.

[edit] Pioneering dates

1895: first pneumonectomy in multiple stages by William Macewen on a patient with tuberculosis and emphysema
1931: first successful pneumonectomy in two stages by Rudolph Nissen on a patient with crush injury to the thorax
1932: first lobectomy, by Harold Brunn
1933: first successful single-stage total pneumonectomy by Graham and Singer
1939: first segmentectomy, by Churchill and Belsey