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Lung Cancer

Post-surgery lobectomy

03/06/2007

Question:

My husband is 9 days post surgery from a bilobectomy for cancer. Although he is clear of the cancer, he still has a chest tube. Two days ago after the tube was clamped his neck and face became swollen and he can hardly speak. His breathing is okay. He is very upset and depressed and still has a lung leak. Our doctors tell us this is not unusual. How long can this go on or how long should we have to wait for this? His depression is overwhelming him in spite of the good news about the cancer being gone. He wants to go home. Can you tell us anything?

Answer:

The really important news is that they successfully resected the cancer, and that there was no evidence of spread.

A prolonged air leak (usually defined as greater than 7 days) is not uncommon after bilobectomy. It is usually not life-threatening. But it is a major nuisance. Occasionally it requires additional surgery; however, it is usually treated successfully with patience.

The swelling (called subcutaneous emphysema) frightens everyone, but is really not a major issue. It represents air leaking from the lung that is unable to exit via the chest tube.

One strategy that you husband’s surgeon may use is called a Heimlich valve. Basically, if the lung stays inflated when off suction (“water seal”), but still is leaking, the chest tube can be attached to a Heimlich (one-way) valve that allows the air to escape while the lung gradually heals (seals). People can frequently go home with a Heimlich valve.

Please feel free to contact NetWellness again if you have further questions.

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Response by:

Michael F Reed, MD Michael F Reed, MD
Assistant Professor of Surgery
College of Medicine
University of Cincinnati