Definition and Overview

Lung surgery consultation is an appointment with a pulmonology, oncology, or thoracic surgeon prior to performing a surgical procedure that involves the lungs.

The lungs are undoubtedly important organs in the body as they are responsible for breathing. They supply the much-needed oxygen to the blood, which is then delivered to various tissues and cells through the vessels as the blood is pumped by the heart. A lung problem, therefore, can cause serious health consequences including a significant reduction of quality of life and in extreme cases, death.

There are many ways to treat conditions that affect the lungs, and a common option is surgery such as lung transplant, lobectomy and wedge resection, among others.

But before any of these procedures can be performed, the patient is scheduled for a pre-surgery consultation with the specialist so he’ll know what to expect, understand the pros and cons of the procedure, and raise any questions or concern about the upcoming procedure.

Who Should Undergo and Expected Results

A lung surgery consultation is ideal for:

  • Patients who have to be evaluated before surgery – The evaluation is necessary to determine whether the patient qualifies for the surgery or not. Factors such as advanced age and pre-existing conditions (such as serious heart problems) can prevent a patient from undergoing such procedure. As a rule of thumb, patients are only given a go signal to undergo an invasive surgery if the benefits outweigh the risks and possible complications.

  • Patients who are scheduled for surgery – For those who qualify for lung surgery, a consultation is scheduled so the patient and the doctor can discuss all concerns and the details of the procedure such as pre-surgical preparation, surgical techniques to be used and follow-up care.

  • Those who need another opinion – Patients always have the option to seek a second opinion or even a third opinion so they can make a well-informed decision.

  • Individuals who may experience complications – It does not matter what type of surgery is performed: there is always an associated risk. However, in certain cases, the complications can be serious or life threatening. A consultation is necessary to reduce the effects or manage these complications.

  • Transplant patients – Lung transplantation is complex, and a consultation helps the patient understand its risks, complications and benefits.

How Does the Procedure Work?

A lung surgery consultation is performed once the pulmonologist, oncologist, or a thoracic specialist refers the patient to a surgeon who specialises in treating lung-related conditions. The surgical consultation is divided into two phases. First is the pre-operation wherein the surgeon will:

  • Obtain an overview of the overall health condition of the patient
  • Request for tests
  • Review medical records
  • Evaluate if the patient is eligible for surgery


The surgeon will also talk about the surgical options, the best technique and equipment to be used and the possible risks and complications that may arise during and after the surgery.

Preparation is one of the keys to a successful lung surgery. As such, the surgeon may outline the dos and don’ts before, during and after surgery like medications to take and activities that the patient can engage in. The patient may also have to be prepared emotionally and mentally. If necessary, the surgeon will refer the patient to a counseling service or a support group. Since surgery is a team effort, the patient will be introduced to the rest of the health care team such as the anesthesiologist.

The second phase is the post-operation, which includes follow-up care. A follow-up is especially important for those with lung cancer as recurrence may happen within the next two years. The interval of visits can vary, but for the next 24 months, the patient may have to visit the surgeon and oncologist every 3 to 4 months.

The phases are not typically completed in one visit. The initial appointment may take around an hour while the succeeding ones are normally shorter (around 30 minutes). The patient is often required to answer a consultation form, which will indicate any health concerns and improvements since the last visit.

Possible Risks and Complications

A consultation is believed to be the best time for the patient and the surgeon to establish rapport and relationship, especially since it is expected that both of them are going to work together for months and even years. The problem sets in if these objectives are not achieved. The patient may not receive prompt treatment, refuse or be less enthusiastic to cooperate, or experience a high level of anxiety, all of which can be hurtful to his health and his chances of having a more successful surgical outcome.

References:

  • Putnam JB Jr. Lung, chest wall, pleura, and mediastinum. In: Townsend CM Jr., Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Saunders Elsevier; 2012:chap 58.

  • Tsiouris A, Horst HM, Paone G, Hodari A, Eichenhorn M, Rubinfeld I. Preoperative risk stratification for thoracic surgery using the American College of Surgeons National Surgical Quality Improvement Program data set: Functional status predicts morbidity and mortality. J Surg Res. 2012: epub ahead of print.

  • Wiener-Kronish JP, Shepherd KE, Bapoje SR, Albert RK. Preoperative evaluation. In: Mason RJ, Broaddus C, Martin T, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine. 5th ed. Philadelphia, PA: Saunders Elsevier;2010:chap 26.

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