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Medically reviewed by Last updated on Oct 31, 2022.

What do I need to know about a thoracotomy?

A thoracotomy is surgery to repair 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 (pocket of pus). It may also be done to remove air or blood trapped inside your chest.

How do I prepare for a thoracotomy?

  • Your surgeon will tell you how to prepare. He or she may tell you not to eat or drink anything after midnight on the day of surgery. Arrange to have someone drive you home when you are discharged from the hospital.
  • Tell your surgeon about all medicines you currently take. He or she will tell you if you need to stop any medicine for surgery, and when to stop. He or she will tell you which medicines to take or not take on the day of surgery.
  • You may need to have blood tests, an electrocardiogram (ECG), and a chest x-ray. You may also need lung function tests. Other tests may be needed depending on what illness or injuries you have. Ask your healthcare provider for more information about these or other tests you may need.

What will happen during a thoracotomy?

  • You will be given general anesthesia to keep you asleep and free from pain during surgery. You will lie flat on your back or on your side.
  • Your surgeon will make an incision in the front or side of your chest. He or she will repair torn blood vessels, organs, or tissues. Tumors, pus, or blood will be removed. He or she may place a tube or drains in your chest. The tube or drains 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.
  • The incision 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.

What should I expect after a thoracotomy?

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. Healthcare providers will watch you closely for problems. Do not try to get out of bed until your healthcare provider says it is okay. A healthcare provider may remove your bandage soon after your surgery to check your incision site.

  • Drains and tubes are used to remove air, blood, or fluid from around your lungs or heart. A nasogastric (NG) tube may be put in your nose and down into your stomach. The tube is attached to suction that keeps the stomach empty. This tube may help get your bowels working. Sometimes food or medicine can be given through the NG tube.
  • Medicines may be given to prevent or treat pain, swelling, fever, or a bacterial infection. Heart medicine may be given to help strengthen or regulate your heartbeat.
  • Deep breathing and coughing help to keep you from getting a lung infection after surgery. Take a deep breath and hold the breath as long as you can. Push the air out of your lungs with a deep, strong cough. Take 10 deep breaths in a row every hour while you are awake. Remember to follow each deep breath with a cough. Hold a pillow tightly against your incision when you cough to help decrease the pain. You should deep breathe and cough every hour while you are awake, even if you wake up during the night.
  • You will be helped to walk around after surgery. Healthcare providers may help you get out of bed to walk after your ET tube has been removed. Ask healthcare providers if there are exercises that you may do while you are in bed. Exercise helps blood move through your body and may help prevent blood clots from forming. Your healthcare provider will tell you when it is okay to get out of bed. Call a healthcare provider before you get up for the first time.
  • Shoulder exercises help make your arms and shoulders stronger. A physical therapist will teach you exercises to help your shoulders move freely and improve the function of your lungs. These exercises may prevent breathing problems after your surgery.

What are the risks of a thoracotomy?

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). PTPS causes 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 develop a life-threatening blood clot. Problems that occur during or after surgery may be life-threatening.

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