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stage."},"fly_home_after_days":{"min":7,"max":10,"unit":"days","qualifier":"After chest drain removal, stable chest X-ray and surgeon clearance; open thoracotomy, air leak or pneumothorax risk extends it."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":7,"max":10,"unit":"days","qualifier":"First review with chest X-ray, before flying home."}},{"purpose":"result_review","requirement":"routine","after":{"min":14,"max":35,"unit":"days","qualifier":"Pathology review and planning of any adjuvant therapy in oncologic cases."}}],"indications":["Early-stage non-small cell lung cancer","Selected carcinoid or other localized primary lung tumors","Selected solitary metastases to the lung","Lobar bronchiectasis, abscess, fungal or TB destruction unresponsive to medication","Congenital lung malformations or severe localized lung damage"],"main_risks":["Prolonged air leak","Pneumonia and atelectasis","Bleeding requiring intervention","Atrial fibrillation and other cardiac arrhythmias","Respiratory failure","Wound infection or empyema","Chronic post-thoracotomy pain","Bronchopleural fistula (uncommon)","Recurrent laryngeal or phrenic nerve injury (uncommon)","Chylothorax (uncommon)","Conversion from minimally invasive to open surgery","Venous thromboembolism"],"pain":"Moderate to significant pain, especially in the first days, managed with multimodal analgesia (regional blocks or epidural, oral and IV drugs). Usually less after VATS/robotic than open surgery; some patients have persistent chest wall pain.","preparation":["Imaging (CT, often PET-CT) and tissue diagnosis where indicated","Pulmonary function tests and cardiopulmonary risk assessment","Staging of mediastinum when indicated","Smoking cessation","Preoperative fasting as instructed by the anesthesia team","Review of current medications with the surgical and anesthesia team","Breathing exercises and conditioning as advised"],"recovery_timeline":[{"phase":"Hospital stay (days 0-5)","description":"Chest drain, pain control, early mobilization and breathing exercises; drain removed when air leak and fluid output settle.","restrictions":["Avoid heavy exertion"]},{"phase":"Early home recovery (weeks 1-4)","description":"Gradual increase in walking, fatigue and incision discomfort improve; breathlessness on exertion may be present.","restrictions":["No heavy lifting","No driving while on opioids or until comfortable and cleared"]},{"phase":"Return to activity (weeks 4-12)","description":"Return to work and graded exercise as cleared by the surgeon.","restrictions":["Avoid strenuous upper-body strain until cleared"]},{"phase":"Late recovery (3-6 months)","description":"Continued improvement in exercise tolerance and breathing; ongoing oncologic surveillance if applicable.","restrictions":[]}],"rehabilitation_days":{"min":28,"max":84,"unit":"days","qualifier":"Ordinary functional recovery to normal daily activities after uncomplicated lobectomy; longer after open surgery."},"result_longevity":"Removal of the diseased lobe is permanent. Lung function loss from resection is lasting, though exercise capacity largely recovers within months. Oncologic durability depends on stage and pathology, and surveillance imaging continues for years.","revision_rate_pct":{"min":2,"max":5,"unit":"percent","qualifier":"Unplanned return to theatre within 30 days, mainly for bleeding or persistent air leak."},"scars":"Minimally invasive (VATS/robotic): several small incisions of about 1-4 cm plus a drain site. Open thoracotomy: a longer curved chest-wall incision, typically 10-25 cm.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation under one anesthesia."},"stages":[{"code":"lobectomy","label":"Surgical removal of one lung lobe with lymph node sampling or dissection when oncologic","after":{"min":0,"max":0,"unit":"days","qualifier":"Performed on the day of surgery."}}],"qualifier":"Standalone single-stage lobectomy; adjuvant therapy is separate and not counted."},"success":{"metric":"5-year overall survival after lobectomy for stage I NSCLC","value":75,"unit":"percent","horizon":"5 years","population":"Adults with pathological stage I non-small cell lung cancer","evidence_status":"limited"},"techniques":[{"name":"Video-assisted thoracoscopic surgery (VATS) lobectomy","suits_whom":"Most patients with early-stage disease and suitable anatomy","recovery":"Shorter hospital stay and less pain than open surgery; return to desk work in about 4-6 weeks."},{"name":"Robotic-assisted lobectomy","suits_whom":"Similar to VATS, where robotic platform and expertise are available","recovery":"Similar to VATS."},{"name":"Open thoracotomy lobectomy","suits_whom":"Larger or centrally located tumors, adhesions, complex anatomy or after conversion","recovery":"Longer hospital stay and recovery, often 6-12 weeks."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":2,"max":4,"unit":"hours","qualifier":"Operative time for a standalone uncomplicated lobectomy; varies with approach and nodal dissection."},"initial_assessment_documents":["Chest CT scan report and images","PET-CT report (if available)","Biopsy or pathology report (if available)","Pulmonary function test results","Electrocardiogram report","List of blood thinners"],"travel_trips":{"min":1,"max":1,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay 7-10 days including hospital stay, chest drain removal and first check. Later reviews can be done locally."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Speak directly with the clinician who will carry out the treatment before booking","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Speak directly to the doctor, dentist or nurse who will be carrying out your treatment before you book your trip.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C2","text":"Check the treating clinician's qualifications and references independently","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Check their qualifications and references independently.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C3","text":"Hold a face-to-face consultation with the operating clinician before the procedure","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"A face-to-face consultation with the health professional who will carry out any planned surgery or treatment must take place before any procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C4","text":"Confirm aftercare arrangements and what happens if complications occur","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Confirm arrangements for aftercare and check what will happen if there are complications, or if you are unhappy with the results of your procedure.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C5","text":"Choose an internationally accredited clinic, knowing accreditation does not guarantee a satisfactory outcome","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/factsheets/travelling-for-treatment-medical-tourism","host":"travelhealthpro.org.uk","quote":"Individuals planning overseas treatment are advised to use internationally accredited clinics or hospitals, although using an accredited clinic or hospital does not guarantee a satisfactory outcome.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C6","text":"Check that you can communicate with clinic staff, ideally in a shared language","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Make sure you are able to communicate; check if you speak the same language as clinic or hospital staff.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"C7","text":"Check communication between the overseas medical staff and the doctor providing care after returning home","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/going-abroad-for-medical-treatment/","host":"nhs.uk","quote":"communication between medical staff abroad and in the UK, such as exchanging medical records and arranging aftercare back home.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Pressure to make a quick decision, or a hard sell, is a warning sign before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist","host":"nhs.uk","quote":"a hard sell a lack of information pressure to make a quick decision no discussion of possible complications no mention of aftercare","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F2","text":"Medical advice offered by a travel agent or sales staff is a warning sign","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Do not accept advice from a travel agent, sales representatives or administrators.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"F3","text":"The patient cannot speak directly with the surgeon who will perform the lobectomy before booking","scope":"treatment_abroad","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Speak directly to the doctor, dentist or nurse who will be carrying out your treatment before you book your trip.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Unexpected difficulty breathing","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/21868-lung-resection","host":"my.clevelandclinic.org","quote":"Have unexpected difficulty breathing","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W2","text":"Blood that soaks through your incision bandage","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/21868-lung-resection","host":"my.clevelandclinic.org","quote":"Blood that soaks through your incision bandage","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W3","text":"Discolored or foul-smelling fluid around incisions","urgency":"contact_clinic","general":false,"source":{"url":"https://my.clevelandclinic.org/health/treatments/21868-lung-resection","host":"my.clevelandclinic.org","quote":"Discolored or foul-smelling fluid around the incisions","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"W4","text":"Chest pain","urgency":"emergency","general":false,"source":{"url":"https://my.clevelandclinic.org/services/thoracic-surgery","host":"my.clevelandclinic.org","quote":"Keep an eye out for chest pain, shortness of breath, bleeding, fever or problems with your incisions.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"The home doctor needs prescriptions to continue the medicines after treatment","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T2","text":"The home doctor needs the images to follow care after treatment","document":"x-rays and scans","source":{"url":"https://travelhealthpro.org.uk/news/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T3","text":"The home doctor may need discharge information when continuing care","document":"discharge documents","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-uk-global-health-insurance-card-ghic/","host":"nhs.uk","quote":"receipts or invoices relating to treatment confirmation that the treatment was state-provided confirmation of payments made to healthcare institutions documents relating to insurance cover if your insurer paid for treatment discharge documents","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},{"id":"T4","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T5","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"The problem is limited to part of one lobe","name":"Segmentectomy","source":{"url":"https://my.clevelandclinic.org/health/treatments/17608-lobectomy","host":"my.clevelandclinic.org","quote":"A surgeon may also do a partial lobectomy, a segmentectomy.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":null},{"id":"A2","text":"The damage is limited to a small section of lung tissue","name":"Wedge resection","source":{"url":"https://my.clevelandclinic.org/health/treatments/21868-lung-resection","host":"my.clevelandclinic.org","quote":"A surgeon removes a wedge-shaped section of lung tissue.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200},"operation_id":405}],"checked_at":"2026-11-13","next_check_at":"2027-11-13","version":1},"technique_details":{"status":"ok","items":[{"id":"video-assisted-thoracoscopic","name":"Video-assisted thoracoscopic surgery (VATS) lobectomy","how_it_works":{"text":"Surgeons pass instruments between the ribs through small chest cuts","source":{"url":"https://my.clevelandclinic.org/health/treatments/17608-lobectomy","host":"my.clevelandclinic.org","quote":"In both types, surgeons use tools they pass between your ribs through small cuts in your chest.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"robotic-assisted-lobectomy","name":"Robotic-assisted lobectomy","how_it_works":{"text":"A robot holds the instruments and camera while the surgeon controls them","source":{"url":"https://my.clevelandclinic.org/health/treatments/24201-thoracic-surgery","host":"my.clevelandclinic.org","quote":"Surgeons can also do minimally invasive surgery with the assistance of a robot that holds the instruments and camera, but the surgeon still controls these.","tier":"tier1_medical","fetched_at":"2026-11-13","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"open-thoracotomy-lobectomy","name":"Open thoracotomy lobectomy","how_it_works":{"text":"A surgeon makes a larger cut and spreads the ribs 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