Right Middle Lobectomy

Right middle lobectomy is indicated whenever the disease process is limited to the right middle lobe. The commonest such indication in the western world is carcinoma of the bronchus. The tumour and involved lymph nodes must be confined to the lobe, and lines of resection through vessels and bronchus should be clear of tumour. When undertaken for pulmonary sepsis, pre-operative physiotherapy may produce a temporary but important improvement in the patient’s condition and help minimise post-operative sputum difficulties. All patients should be instructed pre-operatively in the physiotherapy manoeuvres which will be undertaken post-operatively. Prophylactic antibiotics commenced with the premedication and continued for 24 h have been shown to reduce the incidence of wound infection but will have no influence on the more serious problems of chest infection and infection of the pleural space.