Thoracotomy

Thoracotomy is surgery on the chest using a large cut (incision) to get access to the organs inside. This type of surgery is often used to repair or remove diseased or damaged tissue in the chest.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

  • Possible complications of general thoracic surgery include:

  • Respiratory failure.

  • Severe bleeding (hemorrhage).

  • Nerve injury.

  • Abnormal heart rhythm (arrhythmia).

  • Heart attack.

  • Blocked blood vessel (embolism).

  • Infection.

  • The chest tubes used for drainage after thoracic surgery may cause a buildup of fluid or air in the area around the lungs (pleural space). Both of these conditions can lead to lung collapse, trouble breathing, or other problems.

BEFORE THE PROCEDURE

  • If you are not having emergency surgery, a complete medical history and exam will be done before surgery.

  • If you are a smoker, quit. This improves recovery and decreases complications.

  • Other tests may be done before the surgery. Your surgeon can explain these tests to you. Tests may include:

  • X-rays.

  • MRI.

  • Sputum culture.

  • CT scans.

  • Blood gas analysis.

  • Lung (pulmonary) function tests.

  • Electrocardiography.

  • Endoscopy.

  • Pulmonary angiography.

  • Do not eat for 10 to 12 hours prior to the surgery, or as directed by your surgeon.

PROCEDURE

You may be given medicine to help you relax (sedative) before surgery. An intravenous (IV) access is inserted into your arm or neck to give fluids and medicine. You will be given medicine that makes you sleep (general anesthetic). A tube is placed down your throat, into your trachea for the procedure. The chest is cut open to expose the chest cavity. The incision will be made by your surgeon over the area of the chest which will expose the problem best. The procedure differs depending on what is wrong and what needs to be done. Following the procedure, a chest tube is inserted between the ribs to drain the wound and re-expand the collapsed lung.

AFTER THE PROCEDURE

  • You will be taken to a recovery room and watched closely. Depending on the procedure performed, your breathing tube may be removed, or you may need to stay in the intensive care unit (ICU) with the breathing tube still in place. Ask your caregiver what to expect.

  • Patients usually have moderate to severe pain following this surgery. Pain medicines will be given to keep you comfortable.

  • Chest tubes are watched closely for signs of fluid or air buildup in the lungs. Your caregiver will remove them when it is safe.

  • During the recovery period, respiratory therapists and nurses will work with you on deep breathing and coughing exercises to improve lung function.