Pneumonectomy

 

Pneumonectomy

 

If one lung is irreparably damaged and the other lung is quite normal, the affected lung is removed by surgery. It is done as per  the following indications.

                      1.Cancer of the lungs.

                       2.Extensive tuberculous of the lung.

                       3.Bronchiectasis with multiple lung abscesses.

 

Thoracotomy is done. Pulmonary artery and vein of the lung to be removed, are tied and divided. The main bronchus is also divided and sutured. The phrenic nerve on that side is crushed, so that the diaphragm on that side is paralysed .It rises and helps occlude the space left behind ,by the pneumonectomy.

 

Postoperative care

1.See chapter 4 for general care after any major surgery.

2.The patient is given lateral position. His position is changed every one hour, but he is not put on the side of the surgery because he has two intercostal drainage tube on that side.

3.Two intercostal drainage tubes are connected to underwater seals.

4.The vital parameters are recorded every half an hour.

5.Oxygen is given as long as required .

6.He is given reclining position  when he becomes conscious, so that breathing becomes easier.

7.The wound is inspected for haemorrhage.

8.The drainage is inspected.

9.The patient is encouraged to perform deep breathing exercises and to bring out sputum. Deep breathing prevents atelectasis and bringing out sputum keeps the airway clear.

10.Intrtavenous fluid rate is adjusted ,so that, he gets adequate fluids and not develop pulmonary oedema.

11.Oral fluids are given when he recovers from anaesthesia.

 

Complications

1.Haemorrhage

2.Infection

3.Bronchial fistula.

4.Atelectasis.

5.Congestion of the opposite lung

6.Emphysema.

7.Tension pneumothorax.