Lobectomy of the right lower lobe for lung cancer.

Lobectomy is the treatment of choice for primary non-small cell lung cancer (NSCLC), provided that the patient is fit enough to undergo surgery, the primary tumour is confined to one lobe and there are no distant metastases. Other indications for lobectomy include metastatic disease (with multiple nodules in one lobe or central localisation of metastasis), centrally located benign tumours (such as hamartoma), extensive infectious diseases (such as lung abcess, bronchiectasis), and congenital anomalies (such as congenital cystic adenomatoid malformation-CCAM). A lobectomy of the right lower lobe for squamous cell carcinoma is presented in a 66-year old patient. As there was proven involvement of the mediastinal lymph nodes (stage IIIa-N2), induction chemotherapy consisting of four cycles of gemcitabin and cisplatinum was given. Control CT-scan and FDG-PET scan showed no mediastinal involvement anymore. He was scheduled for surgical treatment. Through a right anterolateral muscle-sparing thoracotomy, lobectomy of the lower lobe with a mediastinal lymphadenectomy was done. Apart from atrial fibrillation, the postoperative course was uneventful.