Definition

A thoracotomy is a surgery to open the chest wall. The surgery allows access to the lungs, throat, aorta, heart, and diaphragm. Depending on the disease location, a thoracotomy may be done on the right or left side of the chest. Sometimes, a small thoracotomy can be done in the front part of the chest.

Reasons for Procedure

A thoracotomy may be done to:

• Confirm diagnosis of a lung or chest disease
• Repair the heart or the vessels of the lung and heart
• Treat windpipe disorders
• Remove a portion of the lung or the entire lung
• Treat throat disorders
• Reinflate lung tissue that has collapsed due to disease or trauma
• Remove pus from the chest
• Remove blood clots from the chest

Possible Complications

If you are planning to have a thoracotomy, your doctor will review a list of possible complications, which may include:

• Bleeding
• Infection
• Damage to the organs in the chest
• Reaction to anesthesia
• Collection of air or gases in the chest
• Persistent pain—rare

Factors that may increase the risk of complications include:

• Major trauma involving multiple body parts
• Age
• Heavy smoker
• Previous stroke or heart attack
• Prior radiation therapy
• Chronic medical problems

What to Expect

Leading up to surgery:

• Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure such as:
  • Aspirin or other anti-inflammatory drugs
  • Blood thinners
• You may be asked to use an enema to clear your digestive system.
• Do not eat or drink anything after midnight.
• To minimize complications, stop smoking at least 2-3 weeks before surgery.

Description of Procedure

You will be placed on your side with your arm elevated. An incision will be made between two ribs, from front to back. The chest wall will then be opened. In some cases, the doctor may take a different approach. The doctor can then do whatever procedure needs to be done in the open chest. When the procedure is done, one or more chest tubes will be placed. The tubes will make sure that blood or air does not collect in the chest. The chest wall will be closed. The incision is closed with stitches or staples and bandaged to prevent infection.

Drainage Tubes and Incision After Thoracotomy

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Call Your Doctor

After you leave the hospital, call your doctor if any of the following occur:

• Difficulty breathing or cough
• New pain in the chest or persistent and severe pain in the area of surgery
• Stitches or staplesthat come apart
• Excessive bleeding at the site of the incision
• Coughing up mucus that is yellow, green, or bloody
• Signs of infection, including fever and chills
• Redness, swelling, increasing pain, excessive bleeding, or discharge at the incision site
• Severe nausea or vomiting
• Pain, burning, urgency or frequency of urination, or persistent blood in the urine

In case of an emergency, call for medical help right away.