This page was reviewed under our medical and editorial policy by
Peter Baik, DO, Thoracic Surgeon
This page was updated on September 26, 2022.
A pneumonectomy—a surgical procedure that removes all of the lung in one side of the chest—is a treatment option for some types of lung cancers, chest injuries or other conditions. It’s a major operation that usually requires general anesthesia for the surgery and several days in the hospital for recovery.
Doctors may perform a standard pneumonectomy or an extrapleural pneumonectomy, which removes a lung and parts of surrounding structures, including the pericardium (tissue covering the heart), diaphragm and parietal pleura (tissue lining the chest cavity). As a cancer treatment, it’s typically done to treat malignant mesothelioma.
A pneumonectomy isn’t the only type of lung surgery. For most lung cancers, pneumonectomy isn't the right option, and in some cases, patients may not have enough lung function to accommodate an entire lung being removed. You and your cancer care team may carefully weigh the risks and benefits of different types of lung surgeries based on the cancer type and location. Doctors will also consider your current lung function and ability to physically withstand an invasive surgery.
Other types of lung surgery include:
These other types of surgeries may be performed using several small incisions, with the aid of a camera on a scope (video-assisted thoracic surgery, or VATS) or of a robotic system (robotic-assisted thoracic surgery, or RATS).
For full pneumonectomies, however, doctors usually perform a thoracotomy, in which they make a large incision between the ribs to reach the lungs Generally, it takes longer to heal after a thoracotomy (one big incision) than a VATS or RATS (several smaller incisions).
A pneumonectomy may be performed as part of treatment for a mesothelioma or other types of lung cancers besides small-cell or non-small-cell lung cancers. Because of the increased risks associated with pneumonectomy, a thorough clinical workup should be performed prior to the procedure.
Long before the surgery itself, your cancer care team gathers information that helps them recommend the right type of procedure for you.
Before surgery, you’re likely to undergo tests to check whether:
You may undergo blood tests to check your blood count, blood sugar and risk for bleeding problems, as well as a lung X-ray.
Your care team may also recommend that you complete induction treatment, or an initial treatment, before surgery. In the case of pneumonectomy, this is often chemotherapy—called neoadjuvant chemotherapy, since it’s given before the main treatment.
Begin preparing for a pneumonectomy by asking your care team any questions you may have. Questions may include:
Your care team may have specific instructions for you to follow in the days before and after surgery. Make sure you know how long you should plan to be in the hospital during recovery and how to best prepare your home.
A pneumonectomy is performed by a surgeon in a hospital. You’ll be put under general anesthesia, which means you’ll be unconscious—or in a very deep sleep—during the procedure. You’ll meet with several members of your care team before the procedure. Be sure to ask any questions you have along the way.
After a pneumonectomy, you’ll likely need to stay in the hospital for several days to recover—typically about five to seven days. Your care team sets up tubes—or drains—to shuttle excess fluid and air out of your chest. These drains may be removed once there is no evidence of bleeding, which usually takes one or two days following surgery. Even after the chest tube is removed, because of the significant changes in the body, most patients will remain in the hospital for close monitoring.
For lung cancer that hasn’t spread to the lymph nodes or any other part of the body, the benefit of a pneumonectomy is the high likelihood that it may remove all cancerous cells.
However, a pneumonectomy is a major surgery. Risks of a pneumonectomy include:
The use of general anesthesia always comes with some risks, such as breathing problems, changes to your heartbeat, an allergic reaction or confusion upon awaking.
You may also experience side effects as you recover from surgery. Be sure to ask your care team which side effects to expect, and which ones may be a sign of a problem.
Alert your care team if you have any of these signs after surgery:
Be sure to ask your care team when it’s safe to resume certain activities, such as lifting heavy objects and returning to work.
After surgery, your lung function may or may not be similar to what it was before. Because an entire lung is removed in a pneumonectomy, you may notice a difference in how you breathe. Ask your care team what to expect afterward depending on your type of surgery.
Your care team may follow up to let you know how the surgery went—including if they were able to remove all signs of cancer. Regardless of the results, expect to schedule appointments and tests to make sure the cancer isn’t recurring or spreading. You also may need additional treatment to decrease the chance that cancer may return. This is typically chemotherapy—called adjuvant chemotherapy, since it’s given after the main treatment.