A lung resection is a surgery that removes part or all of a lung, most often to treat lung cancer. The amount of tissue removed ranges from a small wedge-shaped piece to an entire lung, depending on the size and location of the problem. It’s one of the most common thoracic surgeries performed today, and advances in technique have made recovery significantly faster than it was a decade ago.
Types of Lung Resection
Your lungs are divided into lobes: three on the right side and two on the left. Each lobe contains smaller segments, and each segment has its own airway and blood supply. The type of resection you need depends on how much tissue is affected.
A wedge resection removes the smallest amount, just a wedge-shaped piece of lung tissue without following the boundaries of any segment. A segmentectomy removes one to four segments of a lobe while preserving the rest. Both are considered “sublobar” resections and are typically used for small, early-stage tumors or non-cancerous conditions.
A lobectomy, the removal of an entire lobe, is the most common operation for lung cancer. A variation called a sleeve resection removes part of the main airway along with the lobe, then reattaches the airway to the remaining healthy tissue. A bilobectomy removes two lobes of the right lung. And a pneumonectomy removes an entire lung, reserved for cases where the disease is too central or widespread for a smaller operation.
There’s also lung volume reduction surgery, which removes pockets of trapped air in patients with severe emphysema. The goal isn’t to remove disease but to let the remaining, healthier tissue expand and work more efficiently.
Why a Lung Resection Is Needed
Lung cancer is by far the most common reason. When a tumor is caught early enough and hasn’t spread beyond the chest, surgical removal offers the best chance of cure. The surgeon aims to take out the tumor along with a margin of healthy tissue around it.
Cancer isn’t the only indication, though. Chronic lung infections like bronchiectasis, where airways become permanently damaged and prone to repeated infections, sometimes require surgery when antibiotics stop working. In one study of 51 patients who underwent resection for bronchiectasis, about half had the procedure because medical therapy had failed. Others needed it because of coughing up blood (24%), a suspicious mass (18%), or a lung abscess (10%). Traumatic lung injuries, fungal infections, and benign tumors can also lead to resection.
How Surgeons Determine Eligibility
Before scheduling surgery, your medical team needs to confirm that your lungs can handle losing tissue. The key measurements are breathing tests that assess how much air you can forcefully exhale in one second and how well your lungs transfer oxygen into your blood. If both of these values are above 80% of what’s predicted for someone your age and size, surgery can proceed without additional testing.
If either value falls below that 80% threshold, you’ll need an exercise test to measure how much oxygen your body uses during peak exertion. This gives a more realistic picture of how you’ll cope after surgery. Even patients with significantly reduced lung function can still be candidates for resection, as long as their values don’t drop below 20% of predicted, particularly when the tumor sits in an area already damaged by emphysema. Removing that diseased tissue can actually improve breathing in some cases.
Open Surgery vs. Minimally Invasive Approaches
Lung resections are performed one of two ways. The traditional approach, called open thoracotomy, uses a long incision along the back and side of the chest. The surgeon spreads the ribs apart to access the lung directly. It provides excellent visibility but comes with more pain and a longer recovery.
The minimally invasive alternative uses a camera and instruments inserted through small incisions, typically a single 4 to 5 centimeter cut between the ribs. Compared to open surgery, this approach results in shorter hospital stays, less blood loss during the operation, shorter time with a chest drainage tube, and lower rates of complications afterward. Not every patient is a candidate for the minimally invasive technique. Large tumors, tumors in difficult locations, or patients who’ve had previous chest surgery may still require open thoracotomy.
What Recovery Looks Like
After surgery, you’ll have one or more chest tubes draining fluid and air from the space around your lung. The median drainage time for minimally invasive lobectomy is about one day, though some patients need tubes for longer. Once the drainage slows and there’s no air leak, the tubes come out. The drain sites may ooze for several days afterward and need simple bandaging.
Hospital stays have gotten considerably shorter. With minimally invasive lobectomy and modern recovery protocols, the median stay is around 2 days. About half of patients go home on or before that second day, while the other half stay longer, often because of persistent air leaks or pain management needs. Open surgery generally requires a longer stay.
At home, the biggest restriction is lifting. You should avoid picking up anything heavier than 10 pounds for roughly 4 to 6 weeks. Most people can drive locally again at about 3 weeks. Fatigue and shortness of breath during activity are normal in the early weeks and gradually improve over several months.
How Your Body Compensates
Losing lung tissue sounds alarming, but the remaining lung adapts. After a lobectomy, the opposite lung expands significantly to fill the empty space, a process called compensatory growth. The lung on the same side also shifts and expands. The result is that actual post-surgery breathing test values consistently exceed what doctors predicted based on how much tissue was removed.
Interestingly, the compensation pattern differs by procedure. After a lobectomy, the opposite lung does more of the heavy lifting. After a segmentectomy, the remaining segments on the same side contribute more. For patients who had only a single segment removed, there’s little measurable compensation needed at all, suggesting the loss is small enough that the body barely notices. Overall lung function preservation ends up being similar between lobectomy and segmentectomy, even though lobectomy removes more tissue.
Possible Complications
The most common complication specific to lung surgery is a prolonged air leak, defined as air escaping from the cut surface of the lung for more than five days after the operation. This happens in up to 26% of lobectomy patients and up to 46% of those undergoing lung volume reduction surgery. A persistent air leak can lead to a cascade of other problems: collapsed portions of lung, pneumonia, slower mobility because of ongoing chest tube drainage, and in rare cases, infection in the space around the lung.
Other risks include bleeding, infection at the surgical site, irregular heart rhythms (especially common after larger resections), and blood clots. Pneumonectomy carries the highest complication rate because it removes the most tissue, while wedge resections carry the lowest. Your surgical team will weigh these risks against the consequences of leaving the disease untreated, which in the case of lung cancer is almost always the greater danger.