What Is a Pneumonectomy?

Florida’s lung cancer burden remains significant and affects many families, and hearing “you may need your whole lung removed” can stop you in your tracks.

We understand that this can raise questions about breathing, hospital time, and returning to normal near home.

Our goal is to provide clarity. To do that, let’s discuss pneumonectomy, who may need it, key risks, and how recovery works.

What is a Pneumonectomy?

Pneumonectomy is surgery to remove one entire lung—the right or the left—when a smaller operation cannot safely clear the disease. Fortunately, many people can live an active life with one lung after recovery and training.

A pneumonectomy is considered for central lung cancers that involve a main airway, certain mesotheliomas, and some badly damaged or infected lungs when function can’t be saved.

When discussing the procedure, you may also hear related terms:

• A lobectomy removes one lobe.
• A "sleeve" resection removes a lobe plus a short airway segment to avoid taking the whole lung.
• "Extrapleural pneumonectomy" is a more extensive operation used in select mesothelioma cases.

Types of Pneumonectomy

Below are the different types of pneumonectomy procedures your doctor may consider:

Are There Risks to Pneumonectomy?

Major risks after pneumonectomy include:

• Lung injury (acute respiratory distress syndrome, ARDS)
• Bronchopleural fistula (a leak at the sealed airway end)
• Atrial fibrillation (irregular heart rhythm)
• Pneumonia and blood clots

Right-sided pneumonectomy generally carries a higher risk than left-sided because of anatomy and blood-flow differences.

Enhanced Recovery After Surgery (ERAS) pathways lower complications and can shorten the stay. These include good pain control, early walking, and careful fluids.

Who is a Candidate for Pneumonectomy?

A safe plan starts with accurate staging and fitness testing. We check pulmonary function tests (PFTs) and often use a perfusion scan to see how much work the diseased lung is doing.

When numbers are borderline, a cardiopulmonary exercise test measures how your heart and lungs perform together.

We avoid surgery if cancer has spread outside the chest or if heart-lung reserve is too low (such as severe pulmonary hypertension). You can improve safety to reduce complications and speed recovery by:

• Quitting smoking at least a month before surgery
• Focused exercise
• Better nutrition

Pneumonectomy and Other Treatments at ACTC

If pneumonectomy is advised, selection is careful. We look at your scans, lung tests, heart health, and goals.

Most patients have an open approach through a thoracotomy. The first day or two are watched closely for breathing, heart rhythm, and fluids. We also discuss risks and the expected hospital course before any decision.

Radiation

Radiation can help when surgery is not safe or as part of a plan before or after surgery, depending on the cancer’s stage and margins. Your plan aims to control the disease while protecting the remaining lung.

Medical Oncology

Systemic therapy—chemotherapy, immunotherapy, or targeted therapy—may be used before or after surgery based on stage and tumor markers.

The goal is to lower the chance of cancer returning and to treat any cells that have traveled.

Our top-center-trained oncologists coordinate complex thoracic care locally, so decisions and treatments align with current national standards while staying close to home.

Hospital Course and Recovery After a Pneumonectomy

Most patients spend the first 24–48 hours in the intensive care unit so we can monitor breathing, heart rhythm, and blood pressure closely.

The typical hospital stay is about six days when recovery is smooth. After the procedure, pain control is a priority. An epidural catheter or a nerve block can reduce pain, help you breathe deeply, and lower the risk of pneumonia.

Walking early, eating early, and careful fluid management are parts of “enhanced recovery” pathways.

Home Recovery

Some patients go home with oxygen. Many can wean off over the next weeks to months as the remaining lung gets stronger.

You can ask your doctor when you’re cleared for other activities, such as:

• Driving: When off opioids and able to brake and turn safely.
• Lifting: Usually no more than 10 pounds for about 6–8 weeks.
• Flying: After a pneumonectomy, some programs recommend waiting for several weeks. Plan air travel only after your team confirms you’re safe and, if needed, arrange hypoxia (“fit-to-fly”) assessment.

Call us right away if you notice:

• Fever, chills, or new productive cough
• Worsening shortness of breath at rest
• New chest pain or fast heartbeat
• Redness, drainage, or opening of the surgical cut

Follow-up and Life with One Lung

After your procedure, expect frequent visits and chest CT scans for the first two years, then gradually less often. Many people return to a good daily routine—walking, light chores, time with family—though long-distance walks or heavy lifting may feel different. 

Pulmonary rehab improves endurance and confidence. If you work, desk jobs may resume in 6–8 weeks; physically demanding jobs often take longer and may need adjustments.

For further questions, you can call 352-345-4565 or book an appointment.