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Lobectomy

Lobectomy

December 14, 2021
Emily Cassidy, MD
Emily Cassidy, MD

Cardiothoracic Surgery

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The gold standard lung cancer operation is the lobectomy, which is removal of one of the lobes of the lung. And again, on the right side, we have three lobes, upper, middle and lower. On the left, we have two: upper and lower. They’re all different shapes and sizes. For a lung cancer that we feel confident is confined to the lung or just to that hilum, lobectomy is designed to remove that lung cancer in its entirety. The way that’s accomplished, each lobe has its own blood supply. So its own artery and vein. They also each have their own airway. So depending on the approach, whether it’s open, VATS, or robotic, each of those structures will need to be isolated and divided, typically with a stapler. Once the lobe is removed, the lymph nodes that are on that entire side of the chest are removed as well. That all goes to the pathologist for a complete staging. And after a lobectomy, a final pathology report will be issued by the pathologist, which gives the definitive stage. Meaning, what is the exact size of this tumor under the microscope, the actual diameter of how far those tumor cells extend. Does the tumor invade the pleura? Does it invade the lymphatics or the blood vessels? All of that determines the T stage. And then with regard to the N stage, are there any lymph nodes that are involved? If so, what are the locations of those lymph nodes? And that’ll give a stage of N 1, N 2, so on and so forth.