Introduction
Pneumonectomy is a surgical procedure in which one lung is removed due to a tumor, trauma, and other systemic diseases. The function of one or both the lungs is impaired due to these conditions. The severely impaired lung is removed. A person can lead a normal life with one active lung. The lungs are known as the vital respiratory organs of the body.
What Is the Purpose of Removing One Lung?
The reasons for removing one lung are as follows;
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Pulmonary Metastasis - The growth of cancer cells in the lungs causes lung tumors. The surgeon removes the lung tissue affected by the tumor. But if the tumor is widespread over the entire lung, then the lung has to be removed. This prevents the tumor from spreading to the other lungs.
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Lung Injury - The inhalation of toxic gas or smoking and trauma disrupts the endothelial tissue of the lungs. This condition is called acute respiratory distress syndrome. It is a fatal disease. So the severely affected lung is removed to increase the lifespan of the patient.
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Fungal Infections - The areas affected by fungus appear black on the investigations. If the lung affected by fungus is not removed, there is a chance of spreading to another lung.
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Pulmonary Tuberculosis - The bacteria called Mycobacterium tuberculosis cause the accumulation of mucus in the lungs. This mucus blocks the airways (bronchial tissue) and interferes with inhalation and exhalation. If the lung is damaged due to the bacteria, then it is removed.
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Congenital Lung Diseases - The cyst formed in the lungs during the prenatal stage causes congenital lung disease. It results in tachypnea; the baby has a rapid breathing abnormality. If the disease becomes intense in the future, a pneumonectomy is done.
What Are the Changes That Occur in the Body After the Removal of a Lung?
The body undergoes a few changes after the removal of one lung. The body tries to adapt to the new normal. The body changes are as follows;
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The lungs exhale the waste gases after inhaling oxygen. However, one lung can manage the respiratory mechanism if it has a better working efficiency. The loss of oxygen is compensated with one lung.
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The person has to be cautious during vigorous physical activities like weight lifting and running. Athletes have to take special care during training.
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The active lung tries to adapt to the space of the missing lung. So the X-ray shows a slight expansion in the active lung.
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The person with two lungs has an increased lung capacity than the person with a single lung. The person with one lung should slow down and adapt to the respiratory mechanism.
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A person with one lung does not always need to be in oxygen therapy. But normal life activities can be affected by exertion.
What Are the Systemic Conditions Associated With One Lung?
There are many complications associated with the presence of only one lung. They are as follows;
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Respiratory Failure - Due to respiratory failure in the active lung, the vital organs are unable to get an adequate level of oxygen. These organs cannot undergo regular metabolic activity.
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Bleeding - The injury or scarring in the lung tissue due to fibrosis leads to excess bleeding inside the lungs. This results in shock.
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Arrhythmia - The respiratory rate of one active lung is less than the normal respiratory rate. The heart rate is abnormal due to the alteration in the respiratory rate.
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Blood Flow - Lungs carry pure blood to all organs of the body. The blood flow to the heart decreases due to the removal of one lung.
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Pulmonary Embolism - The embolus formation blocks the main blood vessel of the lungs and decreases the blood flow. It also prevents the supply of oxygen by the lung to the tissues of the body.
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Pneumonia - Normal lungs filter the waste products. These waste products are removed during exhalation. The microbial infection increases the pus or fluid accumulation in the lung. It causes pneumonia.
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Chronic Bronchitis - If the person is a smoker, it causes inflammation in the airways. This condition is called chronic bronchitis. It has potential risks in patients with one lung.
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Emphysema - The small air sacs present in the respiratory system are called alveoli. The rupture of air sacs due to smoking causes emphysema. The patients have shortness of breath in emphysema conditions.
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Pneumothorax - The removal of one lung creates extra space in the chest. In most cases, the air gets distributed inside the body and dissipates itself. But if the air occupies the space, the patient has severe abdominal pain. This condition is called pneumothorax.
What Are the Investigations Taken Before Proceeding With Pneumonectomy?
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Chest X-Rays - The heart, lungs, and the pleural cavity (chest) must be normal for pneumonectomy. These structures are observed with the help of chest X-rays.
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CT Scan - Computed tomography (CT scan) is necessary to get additional information about the tumor or inflammation in the lungs. The position of the lungs is pictured using a CT scan.
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Pulmonary Function Test - The lung capacity, volume, and respiratory rate must be normal to proceed with the pneumonectomy procedure. So the pulmonary function test is done to calculate the vital capacity and residual capacity.
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Electrocardiogram - The heart rhythm is recorded using an electrocardiogram. The vital signs like heart rate, respiratory rate, and blood pressure should be normal for pneumonectomy. In the case of pulmonary embolism, an electrocardiogram shows variable changes.
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Ventilation Perfusion Scan - This scan is usually taken during pneumonectomy to identify the areas in the lungs contributing to respiration. It shows the level of oxygen and blood flow in the lungs. Any mismatch in the ventilation-perfusion scan must be treated.
Conclusion
The ability to survive with a single lung varies from person to person, depending on the function of the active lung. The recovery rate after the removal of one lung varies from one person to other. It may take around four weeks to two months. If the patient has a preexisting respiratory disease, then the symptoms must be carefully monitored to avoid complications. A single healthy lung can deliver the required oxygen level.
However, individuals must take necessary preventive measures to protect themselves from infection. Avoid febrile respiratory disorder by wearing a mask. Since the lung is a major organ, protect it from viral infection using disinfectants. The individual may be weak due to recent lung transplantation, so avoid doing exercise, especially with a single lung. Unlike the liver, the lungs cannot regenerate. So the individual should be careful in maintaining their respiratory system with proper follow-ups.
