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Thoracotomy


Why is this procedure done?


A thoracotomy is a procedure done to open the chest wall. This opening gives the doctors access to the heart, lungs, food tube called the esophagus, the aorta, and the spine. It is done for reasons like to: ‚  
  • Remove cancer or tumor in the lung
  • Treat a very bad chest or heart injury


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What will the results be?


  • Remove and treat cancer
  • Control very bad bleeding from a chest injury
  • Repair the heart

What happens before the procedure?


In an emergency, there are no preparations needed. ‚  
  • Your doctor will take your history. Talk to your doctor about:
  • Talk to your doctor about:
    • All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
    • Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
    • When you should stop eating and drinking before the surgery
  • Your doctor will do an exam and may order:
    • Pulmonary and heart function tests
    • X-ray
    • CT scan
    • Electrocardiogram (ECG)

What happens during the procedure?


  • Once you are in the operating room, the doctor will give you a drug called anesthesia. This will make you sleep and stay pain free during the procedure. The staff will put an I.V. in your arm to give you fluids and drugs.
  • The staff will connect a breathing machine to your mouth. This machine will help you breath during the surgery. The doctor may need to remove the air from a lung during the procedure.
  • The location of the cut or opening on your chest will depend on the reason for this procedure.
  • The doctor will make a 4 to 6 inch (10 to 15 centimeters) cut through your chest wall to open the chest cavity. The doctor will do the work that is needed to be done.
  • The doctor will put air back in your lung if it needed to be collapsed. A tube may be put in your chest to drain fluid.
  • The doctor may put a metal plate or screws in your chest to hold everything in place until the wound heals.
  • Your doctor will close your cut with stitches or staples and cover it with clean bandages.

What happens after the procedure?


  • You will go to a Recovery Room after the surgery. The staff will closely monitor you, including your blood pressure, heart rate, and breathing rate.
  • You will feel pain after the surgery. The staff will give you drugs and fluids through an I.V. line.
  • The staff will assist you on how to do coughing and deep breathing exercises. This will help you clear your lungs and prevent infection.
  • The doctor may order a chest x-ray to see how your lungs are doing.
  • Your doctor will tell you when you may go home. You may stay in the hospital for about a week.
  • If metal plates or screws were placed in your chest, you will be given a medical ID or bracelet that gives your condition.

What care is needed at home?


  • Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
  • Take your drugs as ordered by your doctor.
  • Talk to your doctor about how to care for your cut site. Ask your doctor about:
    • When you should change your bandages
    • When you may take a bath or shower
    • If you need to be careful with lifting things over 10 pounds
    • When you may go back to your normal activities like work or driving
  • Be sure to wash your hands before touching your wound or dressing.
  • Get lots of rest. Avoid tiring activities. Do not lift heavy things for about 2 weeks.
  • Drink lots of water.
  • Do not smoke.

What follow-up care is needed?


  • Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
  • If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
  • Ask your doctor about heart or lung rehab to help you get back on your feet.

What lifestyle changes are needed?


Let airport personnel know that you have chest metal plates or screws before going through security. ‚  

What problems could happen?


  • Bleeding
  • Infection

When do I need to call the doctor?


  • Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, wound that will not heal.
  • Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
  • Trouble breathing
  • Coughing up blood
  • Pain that does not go away with drugs

Where can I learn more?


American Association of Cardiovascular and Pulmonary Rehabilitation ‚  
http://www.aacvpr.org/CardiacRehabilitationPatients/tabid/503/Default.aspx ‚  
http://www.aacvpr.org/ResourcesforPulmonaryRehabilitationPatients/tabid/501/Default.aspx ‚  

Consumer Information Use and Disclaimer


This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚  

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