Pneumonectomy is the medical term for the surgical removal of a lung.


A pneumonectomy is most often used to treat lung cancer when less radical surgery cannot achieve satisfactory results. It may also be the most appropriate treatment for a tumor located near the center of the lung that affects the pulmonary artery or veins, which transport blood between the heart and lungs. In addition, pneumonectomy may be the treatment of choice when the patient has a traumatic chest injury that has damaged the main air passage (bronchus) or the lung's major blood vessels so severely that they cannot be repaired.


Pneumonectomies are usually performed on patients with lung cancer, as well as patients with such noncancerous diseases as chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. These diseases cause airway obstruction.

Approximately 361,000 Americans die of lung disease every year. Lung disease is responsible for one in seven deaths in the United States, according to the American Lung Association. More than 25 million Americans are now living with chronic lung disease.

Lung cancer

Lung cancer is the leading cause of cancer-related deaths in the United States. It is expected to claim nearly 157,200 lives in 2003. Lung cancer kills more people than cancers of the breast, prostate, colon, and pancreas combined. Cigarette smoking accounts for nearly 90% of cases of lung cancer in the United States.

Lung cancer is the second most common cancer among both men and women and is the leading cause of death from cancer in both sexes. In addition to the use of tobacco as a major cause of lung cancer among smokers, second-hand smoke contributes to the development of lung cancer among nonsmokers. Exposure to asbestos and other hazardous substances is also known to cause lung cancer. Air pollution is also a probable cause, but makes a relatively small contribution to incidence and mortality rates. Indoor exposure to radon may also make a small contribution to the total incidence of lung cancer in certain geographic areas of the United States.

In each of the major racial/ethnic groups in the United States, the rates of lung cancer among men are about two to three times greater than the rates among women. Among men, age-adjusted lung cancer incidence rates (per 100,000) range from a low of about 14 among Native Americans to a high of 117 among African Americans, an eight-fold difference. For women, the rates range from approximately 15 per 100,000 among Japanese Americans to nearly 51 among Native Alaskans, only a three-fold difference.

Chronic obstructive pulmonary disease

The following are risk factors for COPD:



In some cases, the diagnosis of a lung disorder is made when the patient consults a physician about chest pains or other symptoms. The symptoms of lung cancer vary somewhat according to the location of the tumor; they may include persistent coughing, coughing up blood, wheezing, fever, and weight loss. In cases involving direct trauma to the lung, the decision to perform a pneumonectomy may be made in the emergency room. Before scheduling a pneumonectomy, however, the surgeon reviews the patient's medical and surgical history and orders a number of tests to determine how successful the surgery is likely to be.

In the case of lung cancer, blood tests, a bone scan, and computed tomography scans of the head and abdomen indicate whether the cancer has spread beyond the lungs. Positron emission tomography (PET) scanning is also used to help stage the disease. Cardiac screening indicates how well the patient's heart will tolerate the procedure, and extensive pulmonary testing (e.g., breathing tests and quantitative ventilation/perfusion scans) predicts whether the remaining lung will be able to make up for the patient's diminished ability to breathe.


A patient who smokes must stop as soon as a lung disease is diagnosed. Patients should not take aspirin or ibuprofen for seven to 10 days before surgery. Patients should also consult their physician about discontinuing any blood-thinning medications such as coumadin or warfarin. The night before surgery, patients should not eat or drink anything after midnight.


In a conventional pneumonectomy, the surgeon removes only the diseased lung itself. The patient is given general anesthesia. An intravenous line inserted into one arm supplies fluids and medication throughout the operation, which usually lasts one to three hours.

The surgeon begins the operation by cutting a large opening on the same side of the chest as the diseased lung. This posterolateral thoracotomy incision extends from a point below the shoulder blade around the side of the patient's body along the curvature of the ribs at the front of the chest. Sometimes the surgeon removes part of the fifth rib in order to have a clearer view of the lung and greater ease in removing the diseased organ.

A surgeon performing a traditional pneumonectomy then:


Chest tubes drain fluid from the incision and a respirator helps the patient breathe for at least 24 hours after the operation. The patient may be fed and medicated intravenously. If no complications arise, the patient is transferred from the surgical intensive care unit to a regular hospital room within one to two days.

A patient who has had a conventional pneumonectomy will usually leave the hospital within 10 days. Aftercare during hospitalization is focused on:

If the patient cannot cough productively, the doctor uses a flexible tube (bronchoscope) to remove the lung secretions and fluids.

Recovery is usually a slow process, with the remaining lung gradually taking on the work of the lung that has been removed. The patient may gradually resume normal non-strenuous activities. A pneumonectomy patient who does not experience postoperative problems may be well enough within eight weeks to return to a job that is not physically demanding; however, 60% of all pneumonectomy patients continue to struggle with shortness of breath six months after having surgery.


The risks for any surgical procedure requiring anesthesia include reactions to the medications and breathing problems. The risks for any surgical procedure include bleeding and infection.

Between 40% and 60% of pneumonectomy patients experience such short-term postoperative difficulties as:

Over time, the remaining organs in the patient's chest may move into the space left by the surgery. This condition is called postpneumonectomy syndrome; the surgeon can correct it by inserting a fluid-filled prosthesis into the space formerly occupied by the diseased lung.

Normal results

The doctor will probably advise the patient to refrain from strenuous activities for a few weeks after the operation. The patient's rib cage will remain sore for some time.

A patient whose lungs have been weakened by noncancerous diseases like emphysema or chronic bronchitis may experience long-term shortness of breath as a result of this surgery. On the other hand, a patient who develops a fever, chest pain, persistent cough, or shortness of breath, or whose incision bleeds or becomes inflamed, should notify his or her doctor immediately.

Morbidity and mortality rates

In the United States, the immediate survival rate from surgery for patients who have had the left lung removed is between 96% and 98%. Due to the greater risk of complications involving the stump of the cut bronchus in the right lung, between 88% and 90% of patients survive removal of this organ. Following lung volume reduction surgery, most investigators now report mortality rates of 5–9%.


Lung cancer

The treatment options for lung cancer are surgery, radiation therapy, and chemotherapy, either alone or in combination, depending on the stage of the cancer.

After the cancer is found and staged, the cancer care team discusses the treatment options with the patient. In choosing a treatment plan, the most significant factors to consider are the type of lung cancer (small cell or non-small cell) and the stage of the cancer. It is very important that the doctor order all the tests needed to determine the stage of the cancer. Other factors to consider include the patient's overall physical health; the likely side effects of the treatment; and the probability of curing the disease, extending the patient's life, or relieving his or her symptoms.

Chronic obstructive pulmonary disease

Although surgery is rarely used to treat COPD, it may be considered for people who have severe symptoms that have not improved with medication therapy. A significant number of patients with advanced COPD face a miserable existence and are at high risk of death, despite advances in medical technology. This group includes patients who remain symptomatic despite the following:

After the severity of the patient's airflow obstruction has been evaluated, and the foregoing interventions implemented, a pulmonary disease specialist should examine him or her, with consideration given to surgical treatment.

Surgical options for treating COPD include laser therapy or the following procedures:



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Pneumonectomies are performed in a hospital by a thoracic surgeon, who is a physician who specializes in chest, heart, and lung surgery. Thoracic surgeons may further specialize in one area, such as heart surgery or lung surgery. They are board-certified through the Board of Thoracic Surgery, which is recognized by the American Board of Medical Specialties. A doctor becomes board certified by completing training in a specialty area and passing a rigorous examination.


Also read article about Pneumonectomy from Wikipedia

User Contributions:

Thanks for the very clear article, it was very helpful in understanding what my father's situation is.
I just like to thank you for having this information out there my uncle just had a Pheumonectomy. He has lung cancer in the left one. This really made it simple to understanding what all is involved.
Sue van der Merwe
Thank you for such am easy to understand article. My mom is going in for a Pneomonectomy this Wednesday, she has just turned 70. I am unfortunately not with her and no one has been able to assist with this information. Thank you, now i know what is happening and feel better equipped to be there for her, and better equipped to deal with this as a whole. GOD bless you.
This article is written very well for the lay person. My brother had his left lung removed a few weeks ago and was discharged after a week. He is in a lot of pain and only when he went to his GP did he find out that his ribs would have been broken during surgery. He thinks that he will need to have chemotherapy or radiotherapy as the cancer has spread to the lymph nodes.Thank you for explaining all this in your article
i had a lung op at 9 yrs of age, part removal of left lung, also had throat incision, had to learn to talk again, never knew why ? op took place ? that was 46 yrs ago. still uninformed of my medical history no records available ? previous GPs now deceased, as are parents etc. what was this op for ? why did it take place ? guess i'll never know the truth ?
I had my left lung removed at age 36. I am now 52. I had experienced chest pain and SOB from age 22. I had bronchoscopy, thorocoscopy, and pleuresy at different times. Just before the emergency surgery I was having the recurrent SOB again. I had a bronchoscopy, revealing calcification, which was agititated, causing bleeding. What was supposed to be an outpatient procedure turned into 3 days in the hospital. After returning to work for one day, I awoke the following morning coughing blood. My curosity is, what was the cause? I did not have cancer. Tuberculosis was ruled out with post-op testing. There is no family history of this condition. Any information on this would be greatly appreciated.
what are the post operative exercises after pmeumonectomy?
once the pneumonectomy is done what happens to the left ventricle and left aorta
dennis werner
My wife had her right lung removed Monday. She has a great deal of pain.She will now see her oncologist for chemo and I imagine radiation as well. Fortunately they said it does not look like it spread but removed some lymphnodes. I hope she has a long life. She just turned 65 and she is an avid golfer
I had a pnuemonectomy 3 weeke ago. My pain was takencare of but lately i have no appetite, the thoughtnof eating is upsetting. Since i will be looking ahead for chemo treatment, i really need to eat. I also know pain medication can curtail appetite so i have weened myself off of that medication. Another irritation is the costant bubbly belching in ne stomach. Anyone else with those symtom
pramod jaiswar
My little sisters left lung pneumonectomy schedule today she is only 10 year old and weight 16 kg . I am fearing about surgery...what will happen..pls ask me abt high risk
My left lung was removed due to cancer 15 years ago. The incision for the surgery was located on my back. Of all the research I've done, I have not come across any pneumonectomy surgeries performed on the back. It appears that all (?) incisions are made on the side or chest. Does anyone know what reason (if any) would my surgery incision be on my back?
I had a left pneumonectomy 4.5 years ago, and Karen, I have the constant bubbly belching, but only just started last year, have contacted specialist to find out more about it, you can feel a little left in the dark with the things that happen! Lisa, my surgery was also performed on my back.. They just told me that was how they do it... And lastly William, I had to go to speech therapy too, something happened in surgery affecting my vocal chords and I could only whisper ... My voice is restored but not quite to its former glory... Great to be in contact with others who have been through the same...
It’s been 3 months to my pneumnectomy but i still encounter severe pain sometimes and i am unable to run or jog. How much time it would take to have zero pain .
Hi everyone
Thank you one and all for your comments. It gives me comfort to know my experiences are not unique especially with the lack of appetite and gurgling others have reported. My operation was on the 05/12/2018 and I was diagnosed with an infection on the 07/12/2018. This I feel set me back somewhat however blood tests report that the infection has gone. I am looking forward to continuing my rehab and returning to work ASAP.
Take care and good luck for the future.

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