What are the choices of surgical procedures for lung cancer?

  The principles of surgical resection for lung cancer are: complete removal of the primary focus and lymph nodes with potential metastasis in the chest cavity, and preservation of normal lung tissue as much as possible, and total lung resection should be done with caution.  (1) Lung wedge and partial resection refers to wedge-shaped cancer block resection and partial lung segment resection. It is mainly suitable for early stage lung cancer with small size, old and weak, poor lung function or low malignancy of cancer differentiation; (2) Pulmonary segmental resection is the resection of dissected lung segments. It is mainly suitable for peripheral type isolated early lung cancer with poor cardiopulmonary function, or partial central lung cancer with lesions limited to the root of the lung cancer; (3) lobectomy lobectomy is suitable for peripheral type and partial central lung cancer with lung cancer limited to one lobe, and central lung cancer must ensure that no cancer remains in the bronchial stump. If the lung cancer involves both lobes or the middle bronchus, two lobes of lung can be resected: upper middle lobe or lower middle lobe; (4) Bronchial sleeve lobectomy This procedure is mainly suitable for central lung cancer that is located in the bronchus or middle bronchus opening of the lung lobes. (5) Bronchopulmonary artery sleeve lobectomy This procedure is mainly suitable for central lung cancer located in the bronchus or middle bronchial opening of the lung lobes, and the lung cancer also invades the pulmonary artery trunk. In addition to bronchial resection and reconstruction, it is also necessary to perform resection and reconstruction of the pulmonary artery trunk at the same time. If the lung tumor exceeds the main bronchus and involves the bulge or the lateral wall of the trachea but does not exceed 2 cm, tracheal bulge resection and reconstruction or sleeve total lung resection can be performed.  (7) Total pneumonectomy Total pneumonectomy refers to the whole lung on one side, i.e., right or left side total pneumonectomy, and is mainly suitable for lung cancer with good cardiopulmonary function, more extensive lesions, and younger age, which is not suitable for lobectomy or sleeve lung lobectomy. The complication rate and mortality rate of total pneumonectomy are higher, and the long-term survival rate and quality of life of patients are inferior to those of lobectomy, so the indications for surgery need to be strictly grasped.