Operations in lung cancerIn most cases, surgery is used to treat non-small cell lung cancer(NSCLC). But if the tumor is located close to the following structures:

  • heart;
  • trachea;
  • esophagus;
  • major blood vessels;

as a treatment is considered irradiation or chemotherapy , Or a combination thereof.

Israel's ability medicine return lost health. Our company, MC «Tlv.Hospital», offers the organization of operations for lung cancer in Israel - we will find the best doctors, the clinic solve issues related to the stay in a foreign country.

Let us consider the surgical treatment of lung cancer in Israel.

By turning operation is usually not in small cell lung cancer (SCLC), unless it is located in the initial development phase. This is due to the fact that the SCLC is usually already spread at diagnosis, so it is impossible to remove it by using surgery. In small cell lung cancer in most cases the treatment is applied cytostatic agents and radiation, rather than surgery.

If the patient has health problems, severe heart disease, or other pulmonary disease, health condition does not allow for a serious operation. The surgeon will make a thorough examination, will make several tests before being issued a joint decision which treatment would be most appropriate for a particular patient.

Preparation for surgery for lung cancer

Before surgery the patient to meet with a surgeon, an anesthetist. They explain that represents the operation of what to expect after the patient wakes up. This information includes information about what kind of food and drinks can be consumed when the patient is able to move, and so on.

Diagnostic tests helps the surgeon to plan the operation, to determine whether malignant tumor surgically removed:

1.Operabelnaya tumor

  • the tumor can be completely resected during surgery;
  • affected surrounding tissue and lymph nodes may also be removed.

2.Neoperabelnaya tumor.

  • there is no possibility to remove the tumor process;
  • malignancy is considered inoperable if it is too large to be able to resect it; secondary foci appeared in certain lymph nodes, mediastinum, or in other organs; there effusion prevralnoy cavity or pericardium.

Doctors carried out tests to verify that the patient is healthy enough for surgery for lung cancer.

The patient will pass some blood tests. Also - the ECG to the study of the heart. If abnormalities are found, may be needed additional tests - ECG stress echocardiography.

When the supposed removal of the entire lung and completely, the doctor will be required to verify that the patient can breathe normally after that. Investigated lung function. The tests measure the how much air can breathe in and out patient.

Will meet with a physical therapist who will teach breathing exercises and leg. They will need to do after surgery to remove lung cancer. During this period, the patient will be in bed, very little move, which will increase the risk of infection and blood clots. Special exercises will reduce it. For the prevention of thrombosis can be assigned heparin, tinzaparin or dalteparin prior to surgery and two weeks afterwards. Also, the patient will wear special elastic stockings.

Type surgical treatment is determined based on the volume of malignancy and its location within the body.

Surgery for lung cancer in Israel

Removal of lobe

Lobectomy - a surgery to remove lung cancer involves resection of one lobe of the body. The doctor will recommend this type of surgery if the tumor struck only one body segment. Lobectomy is performed most often in the disease. Bilobektomiya - surgery that removed two lobes of the lung.

A small number of patients may be recommended surgery for lung cancer, called sleeve resection. The doctor turns to it in order to avoid removing the entire lung, if the tumor is located in the central part of the body and grows in one of the bronchi. Sleeve resection involves removing the affected bronchus and share where spread of cancer.

Removal of the entire lung

Doctors called the operation to remove the entire lung pneumonectomy. The surgeon would recommend this operative intervention if the process of malignant lung struck central segment and includes 2 or 3 share the left to the right proportion.

Many people are worried that they could not breathe with one lung, but it is not. If you have breathing problems prior to surgery for lung cancer, it is likely that they will remain after. To check whether your goal pneumonectomy, the doctor will carry out breath tests.

Removal of part of the lung

Some operations for lung cancer involves the removal of certain areas of the body. Wedge resection eliminates organ zone that includes one or more lobes. Segmentectomy - a resection of lung sections table of Along with the arteries, veins and respiratory tract. These types of surgery are used if the cancer is diagnosed early and is found only in one small area. If the doctor believes that the abnormal cells may be in a different lung zone, it will not offer these operations.

Laparoscopic surgery to remove lung cancer

The laparoscopic approach surgeons use if you want to remove a tumor in NSCLC, small size (3-4 cm), and in the early stages. This is calledthoracoscopic surgery (VATS) .

The doctor inserts a thoracoscope (a flexible tube with a telescopic camera) through a small incision in the chest, allowing the lungs to examine, using the video tutorial. Then it performs 1,2 or 3 small incision on the side of the chest introduces surgical instruments to perform the surgery.

Removal of lymph nodes

Lymph nodes play an important role in the staging and prognosis of NSCLC, and in planning surgery. During diagnostic tests may show that the malignancy has spread to certain lymph nodes.

N1 - number of cancer struck nodes (peribronchial and / or homolateral) which can be removed by surgery for lung cancer.

N2 - can not be resected tumor process hit mediastinal lymph nodes or bifurcation, the surgery is not considered as an embodiment.

N3 - cancer that has spread to lymph nodes data (mediastinum, lung, or root, or supraclavicular) can not be removed by surgery.

During surgery for lung cancer, the surgeon removes some lymph nodes around the lungs. This is due to the fact that they may contain malignant cells that have separated from the primary tumor. He sends them to the laboratory for examination under a microscope. If the nodes contain cancer, it will affect the treatment that will be required after surgery to remove lung cancer.

Surgery for metastatic cancer

If the tumor has spread, extensive surgery is unlikely to be an appropriate treatment. When cancer cells appeared elsewhere, surgery does not remove them, so your doctor can recommend other therapies - treatment with cytotoxic agents or radiotherapy.

However, the operation may be offered to eliminate solitary metastatic tumors which have spread from the lungs to the brain or adrenal gland.

stent

NSCLC can affect the bronchi, causing difficulty breathing or pneumonia. A stent is a small metal or plastic tube which is placed in the bronchus during bronchoscopy. It keeps the airway open and allows air to enter the lungs.

Installation of drainage pipes

During the operation the flexible tubing positioned through the incision in the skin between the ribs and is inserted into the space between the lungs and the chest wall. The tube is connected to a bottle of sterile water and a vacuum apparatus. In its place secured by stitches or tape.

Drainage tube is used to drain blood and other fluids and air from the space around the lungs (the pleural cavity) after surgery for lung cancer. It remains in place as long as the X-rays did not show that these substances are not available, and can easily turn around completely.

Thoracentesis (pleural puncture)

This is a procedure in which a hollow needle is inserted through the skin into the space between the ribs between the lungs and to eliminate the pleural cavity fluid or air. Thoracentesis in NSCLC is carried out in the following cases:

  1. leakage air from the lungs in the chest, resulting in pneumothorax;
  2. for bleeding into the chest (hemothorax);
  3. when fluid accumulation in the pleural cavity (pleurisy).

pleurodesis

Pleurodesis performed to prevent the accumulation of fluid in the pleural cavity and pleural effusion. Excess fluid is drained and introduced into the cavity through the drainage drugs and chemicals (sterile talc). Pleurodesis seals the parietal and visceral pleura, eliminating the space in which the fluid will accumulate.

After surgery for lung cancer

The patient regains consciousness in the intensive care unit. As soon as the doctors are convinced that his condition is improving, it is moved into the ward. Typically, this occurs in the surgery day.

In intensive care the patient is checked regularly, it provides a constant nursing care. The surgeon and the anesthesiologist closely track changes.

To connect the patient dropper in hand and drains in the wound area. Liquid is introduced into the body through the dropper, until the patient can not independently drinking, it usually occurs within a couple of days. Drains removed when the fluid from the wound is no longer highlighted. It can last up to a week, take a shorter period if the operation was laparoscopic.

As soon as possible the patient will start to stimulate the move. While it is impossible to get out of bed need exercises for breathing and feet to avoid complications - thrombosis and infection.

Regular patient will undergo chest X-rays, so that the doctors could see in normal breathing. First, it will perform in the House with a portable X-ray machine.

Within a few days, the patient will feel pain. There are different types of painkillers, which are used, and different ways of their introduction into the body. Be sure to tell your doctor or nurse about pain. Using the patient's own specialist will select the correct type and dose of painkiller. It is important that the patient felt most comfortable for proper breathing. If the pain is controlled, a person will start to move more easily to reduce the risk of infection.

Occasionally, some people develop pain after weeks or months after surgery for lung cancer. The reason lies in the fact that the damaged nerve endings have started to grow. The pain will pass, when they are restored. This may take some time.

If you experience pain after surgery for lung cancer, it is necessary to consult a doctor to find out the reason for that. If you can not understand immediately, the patient is referred to a specialist in pain clinic.

Hospitalization after removing the light will take approximately 10 days after lobectomy - to 5 - 7 days.

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