Thoracotomy

What you should know

A thoracotomy is surgery to repair any damage to the blood vessels and organs inside your chest. These organs include your esophagus, heart, lungs, and trachea (windpipe). A thoracotomy is also done to remove a lung tumor or an abscess (infection with pus). A thoracotomy may also be done to remove air or blood trapped inside your chest.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may have an allergic reaction to the anesthesia used during your surgery. You may lose more blood than expected during surgery. Some of your ribs may be broken, causing pain after you wake up. After surgery, you may also have pain and trouble moving your arms and shoulders. You may have post-thoracotomy pain syndrome (PTPS). With PTPS you will feel pain at your incision site for 2 months or longer. After surgery, you may feel dizzy, have blood clots, a nerve injury, lung problems, and a decrease in blood pressure. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Problems that occur during or after surgery may be life-threatening.

  • Without surgery, damaged organs in your chest may not be repaired. You may continue to bleed and have trouble breathing. Tumors inside your lung may grow and damage nearby tissues, or spread to other parts of your body. Lung infections and pus will remain and may damage your healthy lung tissues. This may lead to worsening lung problems. These problems may be life-threatening.

Getting Ready

The week before your surgery:

  • Arrange to have someone drive you home after your surgery. Do not drive yourself home.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Tell your caregiver if you know or think you might be pregnant.

  • You may need to have blood tests, an electrocardiogram (ECG), and a chest x-ray. You may also need a pulmonary function test. Other tests may be needed depending on what illness or injuries you have. Ask your caregiver for more information about other tests you may need. Write down the date, time, and location of each test.

  • Write down the correct date, time, and location of your procedure.

The night before your surgery:

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • You will lie flat on your back or on your side. The way you are placed on the operating table will depend on which incision your caregiver uses. One of the following incisions will normally be used for your surgery:

    • Anterolateral incision: Your incision will start at your sternum (breastbone) and go across to your side, just under your armpit.

    • Median sternotomy: Your incision will be made in the middle of your chest. Your sternum will also be split down the middle and spread gently apart.

    • Muscle-sparing incision: This incision may be used to decrease injury to your chest area. The muscle-sparing incision will start on your side behind your nipple line. Your incision will then go up and across to just under your armpit.

    • Posterolateral incision: Your incision will start at your sternum and go across your side to your back.

  • Your caregiver may need to cut through your muscles and tissues to reach certain areas. Your incision will be kept open to allow your caregiver to work inside your chest. Your caregiver will repair torn blood vessels, organs, or tissues, and remove tumors, pus, or blood. He may place a tube or drains in your chest. The tube or drain will help prevent blood from collecting in your chest and help you breathe better. If you bleed more than expected, you may be given blood through your IV. Your chest wound may be closed with a wire, stitches, or staples. A bandage will cover your incision site to help keep the area clean and dry to prevent infection.

After your surgery:

You will be taken to a room or the intensive care unit (ICU) where you can rest. An endotracheal (ET) tube may be left inside your mouth and throat for 1 or 2 days after your surgery. The ET tube is hooked to a machine called a ventilator that will help you breathe. Caregivers will watch you closely for problems. Do not try to get out of bed until your caregiver says it is okay. A caregiver may remove your bandage soon after your surgery to check your incision site.

Contact a caregiver if

  • You cannot make it to your surgery on time.

  • You get a cold or the flu, or you have a fever.

Seek Care Immediately if

  • You cough up or vomit blood.

  • You feel very weak or faint.

  • You have sudden shortness of breath.

  • You have problems thinking or remembering things.

  • You have chest pain.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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