Pneumonectomy

Pneumonectomy is the surgical removal of an entire lung. It is performed for cancers that cannot be treated by removing a smaller portion of lung tissue, including some asbestos-related lung cancers and, in selected cases, malignant pleural mesothelioma. Because the procedure permanently eliminates one lung, it is reserved for patients whose disease is extensive but still potentially controllable and whose overall health can tolerate the operation.

Origin

The word combines the Greek pneumon (lung) and ektomē (excision). The first successful pneumonectomy was performed in 1933 by Dr. Evarts Graham at Washington University in St. Louis on a physician with lung cancer, establishing the procedure in modern thoracic surgery.

Significance in Asbestos Context

For patients with asbestos-related cancer, the question of whether to undergo pneumonectomy is one of the most consequential decisions in their care. In mesothelioma, a more extensive version called extrapleural pneumonectomy (EPP) removes the lung along with the pleural lining, part of the diaphragm, and the pericardium; many specialized centers now favor the lung-sparing pleurectomy/decortication (P/D) instead, and a second opinion at a mesothelioma center is worthwhile before consenting to EPP. In asbestos-related lung cancer, pneumonectomy is used when the tumor crosses lung fissures or involves the main bronchus. The surgical pathology report from a pneumonectomy is often the single most important medical document in a legal claim: when the pathologist documents asbestos bodies, asbestosis, or pleural plaques in the removed tissue, that finding becomes direct physical evidence linking the disease to asbestos exposure. Defense attorneys may argue that smoking, not asbestos, drove the need for surgery, or that the procedure was more aggressive than necessary; your legal team will rely on your treating surgeons and pathologists to address those arguments. Pneumonectomy also typically qualifies claimants for the highest tiers in asbestos bankruptcy trust schedules and significantly increases the documented damages in civil cases because of the permanent loss of lung function, recovery burden, and surgical risk.

Example Sentence

After his pneumonectomy, the pathology report identified numerous asbestos bodies in the resected lung, which his attorneys used to corroborate decades of occupational exposure at the shipyard.

Related Terms

Extrapleural Pneumonectomy (EPP), Pleurectomy/Decortication (P/D), Lobectomy, Malignant Pleural Mesothelioma, Asbestos Bodies, Pulmonary Function Test

Notes

• Ask whether a lung-sparing pleurectomy/decortication (P/D) is an option before agreeing to EPP for mesothelioma; outcomes data and quality-of-life considerations have shifted many centers away from EPP, and a second opinion at a high-volume mesothelioma program (such as Brigham and Women's, MD Anderson, Memorial Sloan Kettering, or the University of Chicago) is reasonable.
• Request the complete surgical pathology report, not just the summary, and give a copy to your legal team. Specifically ask the pathologist whether asbestos bodies, ferruginous bodies, asbestosis, or pleural plaques were identified in the removed tissue, and whether tissue blocks have been preserved for possible fiber burden analysis later.
• Get baseline and post-operative pulmonary function tests (PFTs) and keep copies. Pneumonectomy typically reduces lung capacity by roughly half, and these numbers document disability for both your legal claim and Social Security or veterans' disability applications.
• Confirm in writing exactly which operation is planned (standard pneumonectomy, extrapleural pneumonectomy, or extended pleurectomy/decortication) because recovery, risks, and long-term function differ substantially.
• Perioperative mortality for pneumonectomy is meaningful (commonly cited at 5–8%, higher for EPP), so make sure advance directives, healthcare proxy designations, and any estate planning are completed before surgery.