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Thoracotomy

Thoracotomy is surgery used to diagnose and treat certain lung problems. The surgeon makes a cut (incision) through the skin, usually between the ribs, and then through the lining around the lungs. He or she may take a sample of lung tissue (biopsy). Or the surgeon may take out a tumor or mass, or part or all of a lung. Sometimes surgeons use the thoracotomy for surgery on the esophagus or for certain surgeries on the heart. 

Preparing for Your Procedure

  • Ask your doctor any questions you have about the procedure.

  • Have blood tests or other tests that your doctor suggests.

  • Ask your doctor about donating your own blood in advance of the procedure.

  • If you smoke, stop immediately.

  • Tell your doctor about any medications you're taking (including aspirin), and ask if you should stop them. Also mention any vitamins, herbs, or other supplements you take.

  • Don't eat or drink anything after midnight the night before your procedure, or as directed.

The Procedure

  • The anesthesiologist can discuss the types of medications you'll be given during the procedure and answer your questions. Once you're asleep, you're positioned comfortably on your side and covered with sterile drapes.

  • The lung to be operated on is deflated. A breathing tube helps your other lung continue working. The deflated lung can then be examined and any needed procedure done. In some cases, part or all of the lung and nearby lymph nodes may be removed.

  • Your surgeon then makes an incision across your side. Your rib cage is separated so the surgeon can reach your lungs.

  • When the procedure is finished, one or more tubes are placed in the chest temporarily to drain fluid and air.

  • The rib cage is then repaired. The muscle and skin are closed with sutures or staples.

  • You will wake up in a recovery area, or sometimes in the intensive care unit. Your breathing tube is generally taken out before or just after you wake up.

Risks and Complications

Thoracotomy is generally safe. But like any surgery, it has a small risk of complications. These complications could include: 

  • Risks of general anesthesia

  • Wound infection

  • Bleeding

  • Inflammation of the lungs (pneumonia)

  • Air leak through the lung wall, requiring a longer hospital stay

  • Worsening of any existing heart problems

  • Blockage of a blood vessel in the leg (deep vein thrombosis) with potential for blood clots in the lung (pulmonary embolism) 

 

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