Your Lungs are Fascinating

Your lungs are tireless workers, constantly exchanging oxygen for carbon dioxide 24/7. This vital process is orchestrated by the intricate respiratory system, ensuring your survival with each breath.

Taking 12-15 breaths per minute translates to over 17,000 breaths daily, or a staggering 6 million breaths annually. These two organs are remarkably large, with a combined surface area similar to a tennis court and a network of airways stretching 1,500 miles, roughly the distance from Chicago to Las Vegas. Air travels through the windpipe, branching out into bronchi and then bronchioles, finally reaching tiny air sacs called alveoli where oxygen is exchanged for carbon dioxide in the blood. Divided into lobes, your left lung (slightly smaller with a heart-shaped notch) and right lung (with three lobes) work tirelessly to sustain life. Each lobe receives air from its own branch of the bronchial tree, but their function remains the same – gas exchange. This remarkable redundancy allows individuals to survive with just one lung.

What is Wedge Reduction?

A wedge resection, also known as wedge excision or wedge biopsy, is a surgical procedure performed to remove a small, wedge-shaped portion of tissue from an organ or structure. In the context of lung surgery, a wedge resection involves removing a localized area of lung tissue that contains a lesion, tumor, or abnormality while preserving as much healthy lung tissue as possible.

When is a wedge resection performed?

There are a few reasons why a doctor might recommend a wedge resection:

• Early-stage lung cancer: If lung cancer is detected early and confined to a small area of the lung, a wedge resection can be a curative approach to remove the cancerous tissue while preserving most of the healthy lung function.
• Solitary pulmonary nodules: These are small growths in the lung that can be benign (noncancerous) or malignant (cancerous). In some cases, a wedge resection might be performed to remove the nodule for biopsy (to determine if it's cancerous) or to remove a cancerous nodule entirely.
• Lung infections: In rare cases, a localized lung infection that doesn't respond to antibiotics might necessitate a wedge resection to remove the infected tissue.

Benefits of a wedge resection

• Preserves lung function: Since it removes a smaller section of lung tissue compared to other procedures, a wedge resection allows you to retain more healthy lung tissue, which is crucial for maintaining good breathing function.
• Minimally invasive: Wedge resections are typically performed using VATS (video-assisted thoracoscopic surgery) which is minimally invasive and offers faster recovery compared to open surgery.
• Outpatient procedure or short hospital stay: Depending on your situation, a wedge resection might be performed on an outpatient basis (go home the same day) or might require a brief hospital stay (usually overnight).

Pre-Operation Guidelines

Pre-operative guidelines for pneumonectomy, a major surgery involving the removal of an entire lung, are crucial to assess the patient's suitability and optimize outcomes. Here are some key aspects:

• Pulmonary Function Testing: This is paramount to assess lung function and predict how well the remaining lung will compensate after surgery. Tests like spirometry measure lung capacity and airflow, and the predicted post-operative FEV1 (Forced Expiratory Volume in one second) is crucial. Generally, a minimum FEV1 of 2L is considered acceptable for pneumonectomy.
• Cardiopulmonary Exercise Testing (CPET): This test evaluates the heart and lungs' ability to work together during exercise. It helps assess the patient's tolerance to the increased workload after surgery and identify potential risks.
• Cardiac Assessment: Evaluating heart function is crucial, as pneumonectomy can stress the remaining heart. Underlying heart conditions might need optimization or even rule out the surgery.
• Other Investigations: Additional tests like blood tests, chest X-rays, and CT scans may be necessary to assess overall health, identify any co-morbidities, and ensure the lung is suitable for resection.
• Smoking Cessation: Smoking significantly increases the risk of complications after surgery. Quitting smoking well in advance is highly recommended to improve healing and reduce risks.
• Nutritional Optimization: Maintaining good nutritional status is crucial for wound healing and recovery. Nutritional deficiencies may need correction before surgery.
• Psychological Support:  Pneumonectomy is a major life-altering surgery. Addressing any anxieties and providing psychological support can significantly improve the patient's coping mechanisms.

Postoperative Care and Recovery

After a wedge resection, patients are typically monitored closely in the hospital for a short period to ensure proper recovery. Postoperative care may include:

• Pain management to alleviate discomfort
• Monitoring for signs of complications such as bleeding, infection, or respiratory distress
• Chest physiotherapy to promote lung expansion and prevent complications such as pneumonia
• Gradual resumption of activities and follow-up appointments with the healthcare team to monitor recovery and address any concerns