Recovery After a Lobectomy

What to Expect Following Lung Cancer Surgery

A lobectomy is major surgery usually offered as a treatment for non-small cell lung cancer (NSCLC). As such, you'll need to take your time recovering. After the procedure, you'll go through a period of healing in the hospital and then at home. During this time, you'll be weaned from a ventilator, have chest tubes that were inserted after surgery removed, and resume eating and drinking. How long it will take to fully recover from the removal of an upper lobe, middle lobe, or lower lobe will depend on what type of procedure you have. Be sure you know what the surgery entails and discuss potential complications and your prognosis with your doctor before surgery.

Post-Operative Intensive Care

Immediately following surgery, you'll be taken to the recovery room where you'll be monitored closely for several hours. A chest X-ray may be taken, and vital signs (such as heart rate and oxygen saturation) will be monitored until you are deemed safe to transfer.

For the first day or so you may be monitored in the intensive care unit (ICU). The ICU is designed to take care of people who are very ill. It is not focused on welcoming family and friends. Flowers are not usually allowed, and many people are limited to only a visitor or two at a time.

Some physicians suggest that only close friends and family see you at this time, so you may want to encourage others to visit after you've been transferred to a regular hospital ward.

Ventilator Use

The breathing tube that allowed the ventilator to breathe for you during surgery is sometimes left in place while you're in recovery after a lobectomy. Since this can cause some anxiety, you may continue to be under light sedation until the tube is removed.

In most cases, the breathing tube can be removed on the same day as your surgery. You may require the ventilator longer if a larger portion of the lung was removed or you have a chronic lung condition such as COPD.

While ventilator use does pose some risks, in most cases, you will begin to feel fine once lung capacity improves to the point where you can breathe on your own.

When the ventilator is removed and you become less sleepy, a respiratory therapist will ask you to cough and assist you in the use of an incentive spirometer. This is a device that you breathe into to exercise your lungs and helps to keep the small air sacs (alveoli) in your lungs open.

Chest Tubes

Your incisions will have been closed after the procedure. However, the surgeon will place a chest tube that leads out from the surgical site, which will allow excess fluid and air to drain outside of the chest.

The chest tube will be kept in place until the surgeon is confident that the drainage has stopped and no air is leaking. The removal usually occurs three to four days after your surgery but may take longer if the surgery was extensive.

If the tube is left in longer than normal, it doesn't mean your recovery is going poorly. Instead, surgeons wish to be cautious, and it's easier to leave a tube in place a little longer than to have to reinsert it if needed.

Blood Clots

When you're able, the nursing staff will help you sit up, and, eventually, they will encourage you to get up and walk with assistance. You may not feel like being active, but increasing activity will help you regain your strength more quickly and reduce the risk of developing blood clots.

During your time in the hospital, you should learn how to prevent and recognize blood clots since these are not uncommon in lung cancer patients—both among those who have had lung operations as well as those who have not undergone surgery. The formation of blood clots, also known as venous thromboembolism, significantly impacts your recovery and lowers survival rates.

Length of Hospital Stay

The length of your hospital stay can vary by your age, health status, response to post-operative care, and the type of surgery you had. With an open thoracotomy, which requires a long chest incision and spreading of the ribs, you can expect to stay about 8 days in the hospital; for a minimally invasive video-assisted thoracoscopic surgery (VATS), you may be required to stay five days.

Not only does VATS require a shorter hospital stay, but it also results in fewer surgical complications. However, as a treatment for or early-stage NSCLC, an open thoracotomy and VATS offers similar prognosis and survival rates.

Many people are anxious to get out of the hospital and return to their own bed, only to realize, when they do get home, that they shouldn't have been so quick to leave. Trust that your surgeon will understand when it's a good time to take those steps out of the hospital.

Home Recovery

Returning to your usual lifestyle can be a little frustrating following lung cancer surgery—especially if you were not having a lot of symptoms from your lung cancer prior to the procedure. Some people have found that it helps to notice progress every day—such as having tubes progressively removed.

Focusing on the small steps forward rather than expecting yourself to be "back to normal" can be calming. Even if you were fit and in good health prior to your surgery, healing takes time.

As you recover, you may notice that the fatigue you experience is unlike fatigue you have coped with previously. Cancer fatigue can be frustrating, especially if you are someone who has a hard time slowing down and taking it easy.

Pace yourself when you return home and early on in the day focus on the activities which take the most mental or physical energy. Delegating tasks to others and learning to accept help can enable you to recover faster and ease the helplessness loved ones often feel.

Your doctor will recommend when you should return to work, but even then, there may be some physical restrictions. For instance, you should avoid heavy lifting for the first several months to prevent strain on the chest muscles and incision.

Complications

Complications following a lobectomy procedure are not uncommon. During post-operative care, you may be using a ventilator to assist with breathing in only one lung. This can cause low oxygen levels in the blood, known as hypoxemia, and possible tissue damage. These problems can be life-threatening if conditions aren't carefully monitored and prevented, but researchers continue to look at the ideal way to manage one-lung ventilation.

Even once you are discharged, you need to be aware of some possible problems. Persistent pain, referred to as post-thoracotomy pain syndrome, can sometimes persist for weeks and months.

As surgical pain eases, you may still have issues with your breathing. Even with pulmonary rehabilitation, it can take time to adjust to the reduced lung capacity that results from lung cancer treatment. These are normal; you simply need to persist with recovery and have patience.

Other complications, such as infections and blood clots, warrant immediate medical care. It is important to know the symptoms and when it is time to call a doctor.

When to Call Your Doctor

Call your doctor or seek emergency care if you experience:

  • Pain around the incision that gets worse
  • Sudden shortness of breath
  • Sudden, severe chest pain
  • Fever of 100.4°F or higher
  • Blood, pus, or unusual discharge from the incision
  • Redness, swelling, and pain around the incision
  • Coughing with greenish-yellow or blood-tinged phlegm
  • Dizziness, confusion, or fainting

A Word From Verywell

The recovery period after a lobectomy is different for everyone. To aid in your healing, keep practicing your breathing exercises and make an effort to avoid cigarettes (including second-hand some), respiratory infections (such as the cold and flu), and any environmental toxins, chemical fumes, or smoke.

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