Lobectomy Complications and Prognosis

What are the possible complications of a lobectomy, and what is the prognosis after surgery? Because a lobectomy is a major surgical procedure, complications are fairly common. Your surgeon will discuss these with you prior to your surgery and talk about why she feels the benefits of surgery outweigh the risk. What are these possible complications and risks?

Potential Complications

A lobectomy is a major surgery, and though your surgical team will do everything possible to minimize these risks, it's important to be aware of some of the possibilities so you can make an educated choice ahead of time.

There are several possible complications possible with a lobectomy. Keep in mind that many people do not have any of these complications, and even when complications develop, most people do not have all of these. They are listed here only as possible concerns so that you are aware of potential complications, and not to frighten you. Your doctor would not be recommending surgery if she felt the risks outweighed the benefits of surgery. In addition, at this time surgery is the only treatment for lung cancer which offers the chance for a cure of the disease.

If you are feeling anxious, it can be very helpful to connect with the lung cancer community. You can access people to talk with via lung cancer organizations such as LUNGevity, the Lung Force of the American Lung Association, or the Lung Cancer Alliance, or seek out others to talk with via social media. When looking for lung cancer support use the hashtag #LCSM. This is a very active community spanning the spectrum from oncologists, thoracic surgeons, and researchers, to patients and advocates for lung cancer.

Again, complications are not uncommon, but surgical techniques are continually improving. If it possible for you to have video-assisted thoracoscopic surgery (VATS) this procedure may have fewer complications and a shorter recovery time. Not all surgeons are comfortable doing VATS procedures, and not all lung cancers can be removed with this method. What we do know is that lung cancer surgeries done at medical procedures where a greater number of these surgeries are done are associated with better outcomes. If you are planning to have a lobectomy, check out some of the reasons why getting a second opinion is very important.

Possible complications of a lobectomy include:

  • Prolonged ventilator dependence: A need to be on a respirator for a prolonged period of time after surgery is a common concern for people having lung cancer surgery. 
  • Persistent air leak: After surgery, there is sometimes a persistent air leak requiring a chest tube to be left in place longer than planned.
  • Infections: Infections, especially pneumonia and wound infections, are fairly common complications of surgery. Your doctor will watch you very closely for signs of infection after your surgery and will instruct you to call right away if you should develop a fever or any other new symptoms following your return home.
  • Empyema: An empyema refers to the presence of pus in the pleural cavity (the area between the membranes which line the lungs.
  • Bronchopleural fistula: A bronchopleural fistula is an abnormal connection that may occur between the bronchi (the large airways entering the lungs) and the pleural space (the area between the two membranes that line the lungs.
  • Lobar torsion: Lobar torsion is a side effect of surgery in which part of the lung which remains after surgery becomes twisted. A torsion is a medical emergency but is, fortunately, a rare complication.
  • Bleeding: Bleeding following surgery may occur in some people, and on occasion, it is necessary to go back to the operating room so that your surgeons can explore your surgical site for evidence of bleeding and make any needed repairs.
  • Risks of general anesthesiaSince lung cancer surgery—whether via a thoracotomy or VATS—is done under general anesthesia, it is important to be aware of potential complications of general anesthesia.
  • Heart problemsHeart attacks, abnormal heart rhythms, and stroke are all potential complications.
  • Deep vein thrombosis and pulmonary embolism: Blood clots in the legs (deep vein thromboses or DVTs) are much too common among people who have surgery, and those who have lung cancer have an increased risk of DVTs in the first place. The real trouble arises when these blood clots break off and travel to the lungs (pulmonary emboli.) Wherever you are in your cancer journey, check out these tips on reducing the risk of blood clots with cancer.
  • Kidney problems: Kidney problems such as kidney failure may occur due to several mechanisms related to lung cancer surgery, especially when other conditions such as dehydration are present.

Long-Term Complications

Most complications of surgery are experienced in the days right after surgery, but some may persist, or develop later on. Roughly half of people experience some degree of persistent pain in their chest after surgery. Postpneumonectomy syndrome or thoracotomy pain syndrome are the terms used to describe these uncomfortable sensations which are usually treated by a combination of therapies.

Lobectomy Prognosis

The prognosis following a lobectomy depends on many factors. Some of these include which lobe is removed, the stage of the cancer, sex (women tend to do better than men), and how healthy you are in general prior to surgery.

Bottom Line

A lobectomy for non-small cell lung cancer is the one treatment that may result in a cure. That said, it's important to remember that this is a major surgery with several possible complications. Before recommending a lobectomy your surgeon will carefully evaluate your general medical condition to make sure that she believes you will be able to tolerate surgery, as well as the reduced lung function associated with removing a lobe of your lung. Being open with your surgeon about any concerns you have is extremely important, as is quitting smoking if you smoke.

If you will be having a lobectomy it may help to become involved in the lung cancer community, either through local support groups or through the online support communities available anywhere. There are many people in the lung cancer community who cannot only provide support but help you to understand what those first days and weeks may be like after your surgery.

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  3. American Cancer Society. Surgery for Non-Small Cell Lung Cancer. Updated October 1, 2019.