Thoracotomy

A thoracotomy is an incision into the pleural space, the space between the membranes surrounding the lungs and chest cavity. It is performed to correct a problem within one of the lungs. A thoracotomy allows the surgeon to see the affected area, and to determine exactly how extensive a repair or tissue removal needs to be. If the thoracotomy is performed to treat lung cancer, nearby lymph nodes may also be removed to determine if the malignancy has spread. A thoracotomy may be performed laparoscopically or as open surgery, depending on the extent of the problem and the condition of the patient.

Reasons for a Thoracotomy

A thoracotomy, which requires general anesthesia, may be performed for a variety of reasons, including:

  • Removal of a lobe of the lung (lobectomy)
  • Removal of an entire lung (pneumonectomy)
  • Treatment of a collapsed lung (pneumothorax)
  • Removal of tissue damaged by infection or disease
  • Treatment of the buildup of fluid in the lungs (pleural effusion)
  • Tissue biopsy
  • Treatment of a pulmonary embolism
  • Lung transplant

Risks of a Thoracotomy

A thoracotomy, whether done laparoscopically or as an open procedure, is serious surgery. It involves the same risks as other major surgery, including:

  • Excessive bleeding
  • Blood clots
  • Adverse reactions to anesthesia or medications
  • Post-surgical infection
  • Damage to adjacent organs
  • Breathing problems
  • Hernia at the incision site

Risks of a thoracotomy in particular may include:

  • Pneumonia
  • Leakage of air through the lung wall
  • Worsening of any preexisting heart problems
  • Buildup of fluid in the chest cavity

Recovery from a Thoracotomy

The thoracotomy procedure takes between 2 and 6 hours. After the procedure, the patient will remain in the hospital for 5 to 7 days. Recovery time varies from several weeks to a few months, depending on the overall condition of the patient and on the method of the surgery performed. After a thoracotomy, the patient will temporarily have a drainage tube implanted to remove waste fluids from the chest. To prevent blood clots in the legs, the patient will wear special stockings and receive injections of blood-thinning medication. The patient will also receive intravenous medication to control pain. It will be essential for the patient to learn and practice deep-breathing exercises after a thoracotomy to inflate the lungs and prevent pneumonia or other infection.

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