Pneumonectomy (Whole lung)

A pneumonectomy refers to the surgical removal of the entire lung to treat lung cancer. There are two types of pneumonectomy:

Standard pneumonectomy: removal of the entire lung

Extrapleural pneumonectomy: removal of the entire lung, along with a portion of the diaphragm and the linings of the lung (pleura) and heart (pericardium) on the affected side. Extrapleural pneumonectomy is used to treat mesothelioma, a cancer that affects the linings of the lungs.


Pneumonectomy is usually performed to treat cancers that are

  • Large
  • Affect more than one lobe of the same lung
  • Is located near the centre of the lung
  • Affects a large section of the pulmonary vein or artery (blood vessels connecting the lungs to the heart)

Pneumonectomy may also be performed to treat traumatic chest injuries and chronic obstructive pulmonary disease (COPD) that causes airway obstruction.


Pneumonectomy is performed under general anaesthesia. An endotracheal tube is inserted into your mouth through the windpipe to facilitate breathing during the surgery. Your surgeon makes an incision on your chest on the side of the diseased lung, along the ribs. The ribs are separated and a portion of the rib may be removed to provide a better view and access to the diseased lung. The lung is then collapsed. The major blood vessels and the main air tube (bronchus) of the lung are clamped and tied off. The cut end of the bronchus is closed with stitches or staples. The diseased lung is now removed from the chest cavity. The bronchus and blood vessels are checked for leakage of air and bleeding. Your surgeon then closes the incision in the chest wall with surgical sutures.

Post-operative Care and Recovery

Following surgery, you will have an intravenous (IV) line to provide fluids and pain relieving medicines. The ventilator is removed and you will be asked to cough in order to clear the airways. You will also be taught breathing exercises to prevent infection and inflammation. You will be required to stay in the hospital for 7-10 days. After discharge, you are advised against driving for a week, lifting heavy weights and other strenuous activities. Breathing exercises and mild physical activity like walking are encouraged for better blood circulation and muscle strength. You can get back to work in about eight weeks. Call your doctor immediately in case you develop the following symptoms after pneumonectomy:

  • Shortness of breath or difficulty breathing
  • Increased redness, pain, drainage or swelling around the incision site
  • Chest pain
  • Fever

Risks and Complications

As with all surgical procedures, pneumonectomy may be associated with complications, including:

  • Infection
  • Pain at the incision site and the region where the ribs were cut
  • Pneumonia (infection in the lungs)
  • Excessive bleeding
  • Bronchopleural fistula (an abnormal passageway that develops between the cut bronchus and the space between the layers of pleura)
  • Heart attack or abnormal heart rhythms
  • Stroke
  • Blood clots in the legs that may travel to the lungs
  • Empyema (pus in the pleura)
  • Pulmonary oedema (fluid accumulation in the lungs)
  • Postpneumonectomy syndrome (shifting of the organs in the chest cavity towards the vacant space left by the excised lung)
  • Shortness of breath
  • Kidney failure