The thoracotomy is a surgical procedure to open the chest and perform chest wall and lung surgery. The surgeon makes an incision in the chest wall between the ribs to operate on the lungs. It is done to partially or fully remove a lung. It may be used to drain fluid or pus collected in the pleural space, secondary to bacterial or tubercular infection.
It is often done to treat a cancerous lung. It is also done to treat problems with heart or other structures in the chest such as diaphragm. It can be used to help diagnose a disease.
Thoracotomy vs. Thoracostomy
Thoracotomy or Thoracostomy are two different procedures:
• Thoracotomy: surgery that makes an incision to access the chest. It is done to remove a part or full lung in people with lung cancer or to deal with sequel of Tuberculosis.
• Thoracostomy: A surgical procedure used places a tube in the space between your lungs and chest wall also knowns as pleural space. It is done to drain blood, air or fluid that surrounds the lungs. (Intercoastal Drainage)
What happens during the surgery?
General anesthesia is administered during the whole surgery and epidural a small tube is attached in your spine to deliver pain medicine during the surgery.
While you are positioned on your side, the surgeon will make 6 to 8 inches incision below the shoulder blade between the ribs and reach out to the lungs to perform the surgery.
Some other procedures
The surgery is done using different methods based on your health condition and need. Few of the different procedures include:
– Wedge resection: removal of a wedged piece from the area of your diseased lung, and some healthy tissue around it.
– Segmentectomy: removal of one segment of a lung.
– Lobectomy: removal of the lobe of your diseased lung.
– Pneumonectomy: removal of an entire lung.
– Pleurectomy or Decortication: Removal of thickened lining of the lung or chest wall, secondary to tubercular or bacterial infection.
– Bullectomy: Removal of bullae can be done by thoracotomy or VATS using thoracoscope or staples. (Condition of air leaking air leaking from lungs to pleural space.
Side-effects and Complications
You will likely have some pain and burning sensation in the chest after the procedure. The doctor may prescribe you medicine to reduce the pain. The pain may last weeks. Some of the side-effects are:
– Air Leaking from the lungs
– Blood clot in leg that can travel to lungs and cause blockage.
What can you expect after the surgery?
Regular monitoring of the heart rate, blood pressure, breathing and oxygen level is a standard procedure. You may need to spend a first day after surgery in ICU, and once you stabilize, you will be sent to the hospital standard recovery room. 4-7 days stay in hospital is normal. Breathing may be difficult first, but will ease back to normal. You can return to your daily routine once you feel you are ready. Intense activities must be avoided for six to eight weeks after the surgical procedure.