A lung resection is a surgery to remove part or all of a lung, most commonly performed to treat lung cancer. The procedure ranges from taking out a small wedge of tissue to removing an entire lung, depending on the size and location of the disease. It remains one of the most effective treatments for early-stage lung cancer, with 10-year survival rates reaching roughly 58% to 85% depending on the type of resection and how survival is measured.
Types of Lung Resection
There are four main types, defined by how much tissue the surgeon removes:
- Wedge resection: A wedge-shaped piece of lung tissue is removed, taking out the smallest amount. This is typically used for very small or peripheral tumors.
- Segmentectomy: One to four segments of a lung lobe are removed while preserving the rest. This offers a middle ground between a wedge and a full lobe removal.
- Lobectomy: An entire lobe is removed. Your right lung has three lobes and your left lung has two. This is the most common operation for early-stage lung cancer, accounting for about 87% of resections in large screening studies.
- Pneumonectomy: The entire lung is removed. This is reserved for cases where the tumor is too central or too large for a smaller operation.
The choice depends on the tumor’s size, location, and stage, as well as how much lung function you can afford to lose.
How Surgeons Perform the Operation
Three surgical approaches are used today. Open thoracotomy is the traditional method, requiring a larger incision between the ribs. Video-assisted thoracic surgery (VATS) uses small incisions and a camera to guide the operation. Robotic-assisted surgery (RATS) is similar to VATS but gives the surgeon enhanced precision through robotic instruments.
Minimally invasive approaches have become the standard for most patients. In a study comparing all three methods in high-risk patients, robotic surgery produced the shortest hospital stays and the lowest complication rates. Overall complications occurred in about 36% of robotic patients compared to 48% with VATS and 71% with open surgery. Respiratory complications specifically dropped to 13% with the robotic approach versus 39% and 36% for VATS and open surgery. These differences are especially meaningful for older patients or those with other health conditions.
Who Qualifies for Surgery
Before scheduling a lung resection, your medical team needs to confirm that your lungs can handle the loss of tissue. The key screening tool is a breathing test that measures two things: how much air you can forcefully exhale in one second, and how efficiently your lungs transfer oxygen into your blood. If both measurements come back above 80% of the expected value for your age and size, you’re generally cleared for surgery, including pneumonectomy.
If either number falls below 80%, you’ll need an exercise test to see how your body performs under physical stress. This helps predict whether your remaining lung tissue will support your daily activities after surgery. Some patients with borderline lung function may still be candidates for smaller resections like a wedge or segmentectomy, which preserve more working tissue.
Why Lung Resection Is Performed
Lung cancer is by far the most common reason. For early-stage non-small cell lung cancer, surgery offers the best chance of cure. Lobectomy has long been the gold standard for these cases, though segmentectomy is increasingly used for smaller tumors with comparable cancer-specific outcomes.
Lung resections are also performed for non-cancerous conditions, including chronic infections like tuberculosis that have destroyed a section of lung, bronchiectasis (permanently damaged and widened airways that cause recurring infections), and benign tumors or nodules that need to be removed for diagnosis or because they’re growing.
Long-Term Survival After Surgery
Data from the National Lung Screening Trial provides some of the most reliable long-term numbers available. Among patients with stage IA non-small cell lung cancer (the earliest stage), the 10-year overall survival rate was 58% after lobectomy, 60% after segmentectomy, and 45% after wedge resection. These overall numbers include deaths from all causes, not just cancer.
When looking only at deaths caused by lung cancer, the picture is more encouraging. The 10-year lung cancer-specific survival rate was 74% for lobectomy, 81% for segmentectomy, and 85% for wedge resection. The fact that lung cancer still accounted for more than 55% of deaths after lobectomy underscores why long-term follow-up matters even after a successful operation.
Common Complications
Like any major surgery, lung resection carries risks. In a study of 130 patients who experienced complications, the three most frequent were:
- Pneumonia: 21% of cases, making it the most common complication
- Prolonged air leak: 17% of cases, where air escapes from the remaining lung tissue through the surgical site
- Heart rhythm problems: 10% of cases, typically a type of irregular heartbeat called atrial fibrillation
Minimally invasive approaches generally reduce these risks. Your overall health, age, and lung function before surgery all influence your likelihood of complications.
Recovery Timeline
If you have a lobectomy through a minimally invasive approach (VATS or robotic), expect to stay in the hospital for two to three days. Open surgery typically requires three to four days. You’ll have a chest tube draining fluid and air from the surgical site, which is usually removed before discharge.
Full physical recovery takes at least a month after a lobectomy, though many people need longer to feel completely back to normal. Pain management plays a big role in how quickly you recover, since post-surgical chest pain can limit your ability to breathe deeply and move around. Modern pain control typically combines multiple methods: regional nerve blocks near the surgical site, medications delivered through a small catheter near the spine, and patient-controlled pain relief. This combination approach aims to minimize the need for strong opioids while keeping pain manageable enough for you to participate in breathing exercises and early walking, both of which reduce complication risk.
Life After Lung Resection
The first three months after surgery are the hardest. Physical function takes the biggest hit during this window, regardless of which type of resection you had. Most people see meaningful improvement between three and twelve months, though some don’t fully return to their pre-surgery baseline.
The extent of resection matters significantly. Pneumonectomy has the greatest long-term impact on quality of life. In one study, patients who had an entire lung removed still hadn’t returned to their baseline physical function, pain levels, or shoulder mobility a full year after surgery. Those who had a lobectomy fared considerably better, with most functional scores recovering closer to pre-operative levels.
The surgical approach also makes a difference in daily life. Patients who had minimally invasive lobectomies reported physical functioning, social functioning, and pain levels that were at or better than their pre-surgery baseline. Those who had open thoracotomy reported significantly worse scores in those same categories. If you have a choice between surgical approaches and your surgeon is experienced in both, minimally invasive surgery generally translates to a faster and more complete return to your normal activities.