Definition and Overview

Lung surgery follow-up is an appointment with a lung specialist (pulmonologist) following a surgical procedure.

The lungs are a pair of lobes that are enclosed inside the rib cage. They are composed of blood vessels and sacs that work together to draw in oxygen, which enriches the blood that the heart distributes throughout the body to sustain life. The lungs are also responsible for expelling carbon dioxide, which is the body’s waste product.

Lungs, just like any part and organs of the body, can be damaged for a variety of reasons including but not limited to the presence of infections, diseases and injuries. Although in certain cases, medications and other non-invasive treatments work, there are instances wherein the doctor may recommend lung surgery as the primary and ideal option.

Often, lung surgery is recommended to remove a part or the entire lung (a person can survive with only one lung). In more serious cases, lung transplantation is performed. Regardless of the reason for the surgery, the procedure requires follow-up care.

Who Should Undergo and Expected Results

A lung surgery follow-up is performed:

  • For lung cancer patients – Lung cancer is one of the most common types of cancer that affects both men and women worldwide. Some forms of this condition are aggressive that surgery is almost always the first line of treatment. The follow-up at this point is carried out to monitor the recovery of the patient, especially since complications such as internal bleeding, difficulty in breathing and infection can occur.

  • For those who have undergone a lung transplant – A major concern for lung transplant patients is organ rejection. Follow-up is necessary to ensure that this doesn’t happen or it is mitigated as soon as the symptoms appear.

  • To track spread and recurrence – For those who have undergone lung cancer surgery, oncologists monitor the possibility of recurrence, which normally occurs within the first two years after the end of treatment, which may include chemotherapy and radiotherapy.

  • To encourage smoking cessation – A major part of follow-up care is to ensure that controllable risks are managed. These include smoking cessation. Lung cancer, for example, can be linked to many factors including genetics, but smoking still accounts for 90% of diagnosed cases. Smoking can also lead to progressive diseases such as COPD (COPD).

How Does the Procedure Work?

A lung surgery follow-up is performed right after the procedure. But prior to that, its details are discussed even before the operation. This is to ensure that expectations are clear—that is, the patient must continue to see his doctor even after the treatment has been completed.

The follow-up interval depends on a number of factors, such as the outcome of the surgery, the condition being treated and its severity, the overall condition of the patient and prognosis. If it’s a lung cancer surgery, intervals are shorter during the first two years. In the first year, follow-ups are scheduled every three months. In the second year, the frequency may be three times a year. When the patient has already reached the third to fourth year, twice a year will do. After this period, once a year is recommended.

In each follow-up consultation, the doctor may ask about:

  • Any feeling of discomfort such as chest pain (chest pain is actually common among those who have undergone surgery, but oftentimes, this occurs because the scar is healing)
  • Difficulty in breathing
  • Response to medication
  • Update in medical history including the diagnosis of another illness
  • Lifestyle
  • Activities performed


To ensure the patient’s health, the doctor may recommend tests such as X-ray, CT and MRI scans, and a physical exam. The follow-up may also be used for treatments that are relevant to surgery like chemotherapy and radiotherapy.

Although a follow-up consultation is scheduled at predetermined dates, a patient may request for an immediate and unscheduled appointment if symptoms are experienced.

Possible Risks and Complications

Many patients experience a high level of anxiety at least a few days before the follow-up. That’s understandable, however, since the idea of having complications or experiencing recurrence can be daunting. But this may only prevent the patient from sticking to his follow-up care plan. In turn, the doctor can fail to monitor recurrence or spread, the progress of an existing disease, or the patient’s lifestyle that may be risking his survival. A good relationship between the doctor and the patient, one that’s built on comfort and trust, may help reduce the worry.

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.

Share This Information: