A pneumonectomy is a surgical

Surgery

Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...

 procedure to remove a lung

Lung

The lung is the essential respiration organ in many air-breathing animals, including most tetrapods, a few fish and a few snails. In mammals and the more complex life forms, the two lungs are located near the backbone on either side of the heart...

. Removal of just one lobe of the lung is specifically referred to as a lobectomy

Lobectomy (lung)

Lobectomy of the lung is a surgical operation where a lobe of the lung is removed. It is done to remove a portion of diseased lung, such as early stage lung cancer.See also: Lung volume reduction surgery...

, and that of a segment of the lung as a wedge resection

Wedge resection (lung)

Wedge resection of the lung is a surgical operation where a part of a lung is removed. It is done to remove a localized portion of diseased lung, such as early stage lung cancer....

 (or segmentectomy).

Indications

The most common reason for a pneumonectomy is to remove tumourous tissue arising from lung cancer

Lung cancer

Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...

. In the days prior to the use of antibiotics in tuberculosis treatment

Tuberculosis treatment

Tuberculosis treatment refers to the medical treatment of the infectious disease tuberculosis .The standard "short" course treatment for TB is isoniazid, rifampicin , pyrazinamide, and ethambutol for two months, then isoniazid and rifampicin alone for a further four months...

, tuberculosis

Tuberculosis

Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...

 was sometimes treated surgically by pneumonectomy.

The operation will reduce the respiratory capacity of the patient; before conducting a pneumonectomy, the surgeon will evaluate the ability of the patient to function after the lung tissue is removed. After the operation, patients are often given an incentive spirometer

Incentive spirometer

An incentive spirometer is a medical device used to help patients improve the functioning of their lungs. It is provided to patients who have had any surgery that might jeopardize respiratory function, particularly surgery to the lungs themselves, but also commonly to patients recovering from...

 to help exercise their remaining lung and to improve breathing function.

A rib

Rib

In vertebrate anatomy, ribs are the long curved bones which form the rib cage. In most vertebrates, ribs surround the chest, enabling the lungs to expand and thus facilitate breathing by expanding the chest cavity. They serve to protect the lungs, heart, and other internal organs of the thorax...

 or two is sometimes removed to allow the surgeon better access to the lung.

Types

There are two types of pneumonectomy:

1. Simple pneumonectomy: removal of just the affected lung
2. Extrapleural pneumonectomy (EPP): removal of the affected lung, plus part of the diaphragm, the parietal pleura (lining of the chest) and the pericardium (lining of the heart) on that side. The linings are replaced by Gore-Tex
   Gore-Tex
   Gore-Tex is a waterproof/breathable fabric, and a registered trademark of W. L. Gore and Associates. It was co-invented by Wilbert L. Gore, Rowena Taylor, and Gore's son, Robert W. Gore. Robert Gore was granted on April 27, 1976, for a porous form of polytetrafluoroethylene with a...
   
    in this radical and painful surgery that is used primarily for treatment of malignant mesothelioma. This technique produces the best long-term survival rates for this serious and fatal disease.

Pioneering dates

• 1895: first pneumonectomy in multiple stages by William Macewen
  William Macewen
  Sir William Macewen, CB, FRS, was a Scottish surgeon. He was a pioneer in modern brain surgery and contributed to the development of bone graft surgery, the surgical treatment of hernia and of pneumonectomy .-Career:Macewen was born near Port Bannatyne, Isle of Bute, Scotland in 1848 and studied...
  
   on a patient with tuberculosis
  Tuberculosis
  Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
  
   and emphysema
  Emphysema
  Emphysema is a long-term, progressive disease of the lungs that primarily causes shortness of breath. In people with emphysema, the tissues necessary to support the physical shape and function of the lungs are destroyed. It is included in a group of diseases called chronic obstructive pulmonary...
  
  
• 1931: first successful pneumonectomy in two stages by Rudolph Nissen on a patient with crush injury to the thorax
  Thorax
  The thorax is a division of an animal's body that lies between the head and the abdomen.-In tetrapods:...
  
  
• 1932: first lobectomy, by Harold Brunn
• 1933: first successful single-stage total pneumonectomy by Graham and Singer
• 1939: first segmentectomy, by Churchill and Belsey

External links

• Fuentes, P.Pneumonectomy: historical perspective and prospective insight European Journal of Cardio-thoracic Surgery 23 439–445