Pulmonary Wedge Resection

What is a pulmonary wedge resection?
Why do I need a pulmonary wedge resection?
What are the risks of having a pulmonary wedge resection?
How do I prepare for a pulmonary wedge resection?
What happens during a pulmonary wedge resection?
What happens after a wedge resection?

What is a pulmonary wedge resection?

A pulmonary wedge resection is surgery to remove a small, wedge-shaped (triangular) piece of lung tissue.

Why do I need a pulmonary wedge resection?

  • For diagnostic purposes, or
  • To remove an abnormal area of the lung, a small lung mass or tumour.

You may need a pulmonary wedge resection if you have:

  • A metastatic tumour – that has spread from a previous cancer site which has been fully treated
  • Bullous disease of the lung – a small area of the lung where there is a bullous (looks like a small thin walled balloon) that may have ruptured and caused the lung to collapse
  • Early stage lung cancer – in a localised (small) area of your lung
  • Lung nodules or lesions – in a localised area of your lung
  • Tuberculosis – that is untreatable with medication and other interventions.

A pulmonary wedge resection is most effective when the disease, tumour or lung cancer is found early and only in a small area.

What are the risks of having a pulmonary wedge resection?

Overall, a pulmonary wedge resection is considered safe and effective.

As with any surgery, though, there are some risks. Common risks may include:

  • Bleeding in the chest cavity (rarely)
  • Collapsed lung 
  • Infection
  • Persistent air leak – usually from the staple line through the lung (if this happens, your chest tube may need to stay in for a few extra days).

How do I prepare for a pulmonary wedge resection?

First, your doctor may order tests to make sure that your lungs can tolerate the procedure. Your doctor will organise this for you and tell you what you need to do.

Around two weeks before your surgery, you’ll need to:

  • Be reviewed by a cardiologist – a specialist will check that your heart is safe for the surgery
  • Check with your doctor about taking your medications – you may need to stop taking some medications before your surgery, such as blood thinners; your doctor will talk to you about this
  • Have some important tests – you may need an ECG, chest X-ray, blood tests, lung function tests, cardiac stress test, and nose and groin swabs
  • Plan your transport home – it is your responsibility to arrange transport home; for information, including guidelines and tips for travelling home by car or plane after lung surgery, visit our travel page
  • Prepare your home for your return from hospital – make sure you have someone to collect you from hospital, take you home, and help you with shopping, meals, cleaning and driving
  • Shower with antibacterial soap (from a chemist) daily before coming into hospital – your doctor will recommend a suitable soap brand for you
  • Stop smoking – speak to your doctor if you need help, or phone 13QUIT to get started.

If you take SGLT2 medicine for diabetes, you will need to stop taking them at least 3 days before your surgery; read our Patient Information Guide on SGLT2 inhibitors for diabetes.

On the day before surgery, you’ll need to:

  • Ensure your bowels are opened – ask your doctor for a laxative, if needed
  • Pack a small bag of essentials, like toiletries and glasses – your bag of essentials will be taken to the Intensive Care Unit after your surgery
  • Stop eating and drinking – you’ll need to fast from midnight before your surgery.

On the day of surgery:

  • A member of hospital staff will clip off any hair from your chest – this is done to reduce the potential of infection
  • Remember not to eat or drink anything – you’ll need to keep fasting, and talk to your doctor if you have any questions about this
  • Wear a hospital gown – you’ll also need to remove any makeup, nail polish and jewellery (dentures can be left in).

What happens during a pulmonary wedge resection?

A pulmonary wedge resection can be done in two ways:

  • Thoracotomy – open-chest surgery, where a 15-20cm cut between your ribs to operate and remove the lung tissue.
  • Video assisted thoracoscopic surgery (VATS) – minimally invasive surgery performed through tiny cuts of 3-4cm.

Your doctor will recommend the most suitable approach based on the location and size of the tissue that needs removing.

For both techniques, you will be given a general anaesthetic.

When the wedge resection is finished, the cuts are closed with stitches. Your doctor will insert a tube into your chest to drain air and fluids which helps your recovery.

What happens after a wedge resection?

After your surgery, you will be taken to a Recovery Room or Intensive Care Unit in the hospital for close monitoring.

Once the staff are happy with your progress, you’ll be transferred to a hospital ward.

During this time:

  • Your oxygen will need to stay on for at least the first few hours
  • Your chest drain normally stays in for 2-3 days, depending on the amount of chest drainage and whether there is an air leak
  • You may have a tube in your bladder to measure your urine (this is normally taken out the following morning after surgery).

While in hospital, you’ll see a physiotherapist regularly to help with your breathing, exercising, infection prevention and general recovery.

Other points to be aware of as you recover in hospital include:

  • Breathing – you can expect to feel short of breath for 4-5 days after the operation as your lungs recover, but your breathing will improve
  • Eating and drinking – you will be able to eat and drink the day after your surgery
  • Pain relief – you’ll be given pain relief regularly, and hospital nurses will monitor your pain levels (tell them if you are still in pain after taking medication)
  • Showering – you will need help with showering, and your hospital staff will assist with this.

Expect to stay in hospital for 3-7 days, depending on the technique used for the surgery. Try not to compare yourself to others and don’t worry if you need longer.

When it’s time to leave hospital, your doctor and hospital staff will help ensure you have everything you need for a healthy recovery at home.

Here’s what you need to know about returning home after your wedge resection:

  • Diet – it’s common to have a poor appetite initially, so stick to small frequent meals and make sure you have enough to drink
  • Driving – you will usually be able to drive 2-4 weeks after your surgery, but always check with your doctor first
  • Follow up appointments – you will need to make appointments to see your:
    • GP – one week after you leave hospital
    • Oncologist – two weeks after surgery
    • Surgeon – six weeks after surgery
  • Pulmonary rehab – you can expect a fairly gradual recovery for the first few weeks (you’ll probably start feeling ‘normal’ around 4-6 weeks after surgery); we encourage you to attend a pulmonary rehabilitation program to assist with your recovery
  • Rest – it’s normal to feel very tired for at least the first week, so try to have several rest periods during the day
  • Support – you will need someone to be at home with you for the first few days to help with lifting (shopping, washing, vacuuming, making beds)
  • Test results – the results from your tests will be available around one week after your surgery, and your doctor will contact you to discuss this
  • Wound care – be aware of the following points:
    • Your wounds can take up to four weeks to heal
    • Your stitches will need to be removed 12 days after surgery by your GP
    • You may shower daily and get the wounds wet, but do not soak the wounds; gently pat your wounds dry and avoid using any creams or powders
    • You may have some numbness, tingling or pins and needles around your wounds for up to a few months
    • Some inflammation around your wound is common, particularly around the site where the chest drain was inserted - you’ll be given antibiotics to prevent infection
  • Work – you may need 2-4 weeks or longer off work, so discuss your work plans with your doctor and ask for a medical certificate if needed.

If you notice your wounds becoming red or oozy, or if you have any concerns about your wound healing, please contact your GP or surgeon as soon as possible.