CPT® Code 32442

1. Indications

The procedure described by CPT® Code 32442 is indicated for patients with specific conditions affecting the lung and trachea. These indications may include:

• Malignant Tumors - Presence of cancerous growths in the lung or trachea that necessitate removal to prevent further spread or complications.
• Severe Lung Disease - Conditions such as chronic obstructive pulmonary disease (COPD) or pulmonary infections that have led to significant lung damage.
• Tracheal Stenosis - Narrowing of the trachea that may require resection and reconstruction to restore normal airflow.
• Trauma - Injuries to the lung and trachea that require surgical intervention to repair or remove damaged tissue.

2. Procedure

The procedure for CPT® Code 32442 involves several critical steps, which are detailed as follows:

• Step 1: Incision - A posterolateral thoracic incision is made in the intercostal space, beginning just below the shoulder blade and extending around to the front of the chest. This approach allows for optimal access to the lung and trachea.
• Step 2: Rib Removal (if necessary) - If additional access is required, a rib may be removed to facilitate the surgical procedure.
• Step 3: Lung Deflation and Vascular Control - The lung is deflated, and major blood vessels supplying the lung are carefully ligated and divided to prevent excessive bleeding during the procedure.
• Step 4: Tracheal Mobilization and Resection - The main bronchus is clamped and incised, allowing for the removal of the lung. A segment of the trachea is also mobilized and excised along with the diseased or damaged lung tissue.
• Step 5: Anastomosis - The remaining bronchus of the lung is then surgically attached to the remaining segment of the trachea, creating a broncho-tracheal anastomosis to ensure continuity of the airway.
• Step 6: Closure - A chest tube is placed to facilitate drainage, and the chest incision is closed in layers to promote healing.

3. Post-Procedure

After the completion of the sleeve pneumonectomy, patients typically require close monitoring in a postoperative setting. Post-procedure care includes managing pain, monitoring for signs of infection, and ensuring proper lung function. Patients may have a chest tube in place for several days to assist with drainage and prevent fluid accumulation in the chest cavity. Recovery may involve respiratory therapy to aid in lung function and rehabilitation. The expected recovery time can vary based on the patient's overall health and the extent of the surgery, but follow-up appointments are essential to assess healing and any potential complications.