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Looking for info on RU Lobectomy

kim_klock
Posts: 8
Joined: Aug 2009

Hi everyone, My husband is 62 and dx with NSCLC, squamous cell nodules in right upper lobe. He is a smoker (was) and was staged 3B then down staged to 1A? If there is more than one nodule that makes it 3? I am confused. Anyways, i have read lots of posts of people surviving this surgery but most seemed rather healthy prior to being diagnosed. my husband had esphogeal cancer 2 years ago and had surgery to remove 5 inches of his esph. and replace it with 5 inches of his colon. He has been NED for 16 months, now this. A second primary cancer. He is scheduled for surgery on monday, Oct. 19th. We have a 2 year old daughter and a 5 year old son and i am only 39 and scared to death. He has not been healthy since his original dx 2 years ago. He has emphezema (moderate to severe) and also COPD. his lung capacity is only 55%. has any one else had simular health issues to these and can you give me some hope and what our quality of life will be post surgery. Any info would be appreciated. Thank you so very much.

Oceansand's picture
Oceansand
Posts: 12
Joined: Oct 2009

I had this surgery (RU Lobectomy) June of this year. I did fine recovering. The health issues I had prior was emphezema and COPD. I couldn't even pass the breathing test. I threw away my cigarettes, got on meds, walked three times a day pushing myself hard. In two weeks my lung capacity was up enough for the surgery. First three days after surgery were a little rough, shortness of breath and really tired. Five weeks I took it easy and walked some each day. Its been 41/2 months and today I feel great. Still on meds for breathing. I would have the surgery again in a heart beat. Good luck to you and your dad. Please let me hear from you two. I'll be praying that God will be by his side in his decision. Take care.

kim_klock
Posts: 8
Joined: Aug 2009

Thank you so much Oceansand for the info. I am glad to hear your surgery went well. How long were you in the hospital, did you go to ICU from surgery? Good luck to you on your continued journey of wellness. Kim

Oceansand's picture
Oceansand
Posts: 12
Joined: Oct 2009

I did go to ICU for 24 hrs. (precautionary for everyone I think). Surgery on a Friday and went home the following Monday. Surgery lasted over 6 hrs. and I was pretty much out of it with morphine. I did better than my doctors thought. Since I had around the clock help at home, they agreed for me to come home early. Went to hospital for x-ray this morning then to Dr. Got a good check-up. Please keep me informed and let me hear from you two. I'll be praying, and thinking about you.

OncoSurge
Posts: 21
Joined: Oct 2009

I am going to write some general information.

Right Upper Lobectomy (RUL) is unfortunately a fairly common lung cancer procedure for thoracic surgeons. ICU or not varies on numerous factors.

In general, an open RUL with lymph node removal (thoracic lymphadenectomy) will take around an hour. The patient should be extubated after the operation. If something unusual, may take around 90 minutes.

A RUL & lymph nodes with chest wall resection (i.e. Pancoast) takes around two to three hours. Again, patient should be extubated at the conclusion of the operation.

A minimally invassive ("VATS") RUL and lymph nodes will take around three hours. Again, patient should be extubated at the conclusion of the operation.

As lung cancer patients for the most part have underlying smoking related lung disease (i.e. COPD/Emphysema), modern surgical techniques should be employed to minimize pain. This should start with an epidural (unless contraindicated) or pain pump. Open techniques should employ muscle sparing, rib sparing, and nerve sparing approaches. Every effort should be made to avoid rib fractures and/or nerve compression in retractor. With underlying lung disease, it is absolutely important to extubate as soon after the operation as possible. The longer artificial ventillation is employed, the worse the outcomes and more complications. Patients should be encouraged to employ deep breathing as soon as they are awake. Patients should be walking in the halls the day after surgery. Aggressive pulmonary hygiene is a must.

All patients undergoing major chest surgery require continuous monitoring (~telemetry). The distribution and level of nursing and post-operative patient care varies from hospital to hospital. This may mean that telemetry use requires "ICU" level of care. Some hospitals will require admission to ICU over night. If the individual patient has other risk factors like heart disease, he/she may be observed in the ICU. However, going to the ICU should NOT mean prolonged intubation/artificial ventillation. Every effort should be made to get the patient breathing on their own immediately after surgery.

Because of all the points above, lung cancer surgery should be performed by a trained thoracic surgeon. The longer the operation takes, the harder it is to get the patient back breathing on their own and the increased level of complications.

Best wishes

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