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by Scholten A
(Lung Surgery; Surgery, Lung)

Definition

A thoracotomy is surgery to open the chest.

Reasons for Procedure

This surgery is done to access the chest to diagnose or treat diseases of the lungs, aorta, heart, diaphragm, and spine. For example, the opening may be used to:

  • Remove tumors or lymph nodes
  • Remove blood clots from the chest
  • Remove part or all of the lung
  • Repair the heart
  • Treat a lung that has collapsed due to disease or injury

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Collapsed lung
  • Damage to other organs or structures
  • A buildup of air or gases in the chest

Things that may raise the risk of problems are:

  • Smoking
  • Drinking
  • Chronic diseases, such as diabetes or obesity
  • Major injury to multiple body parts
  • Prior radiation therapy

What to Expect

Prior to Procedure

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Whether you need a ride to and from surgery
  • Tests that will need to be done before surgery

Anesthesia

The doctor will give general anesthesia. You will be asleep.

Description of Procedure

An incision will be made between two ribs on the left or right side of the chest. The chest wall will then be opened. A tube will be inserted to drain fluid or air. Any needed procedure will be done at this time. The chest will be closed. The incisions will be closed with stitches or staples. A bandage will be placed over the site.

Incision and Drainage Tubes
thoracic drains
Copyright © Nucleus Medical Media, Inc.

How Long Will It Take?

About 3 to 4 hours or longer

Will It Hurt?

Pain is common in the first six weeks. Medicine and home care help.

Average Hospital Stay

The usual length of stay is 5 to 10 days. If you have problems you may need to stay longer.

Post-procedure Care

At the Hospital

After the procedure, the staff may:

  • Give medicines to control pain and nausea
  • Remove any tubes placed during surgery
  • Teach exercises to promote breathing

During your stay, the hospital staff will take steps to lower your risk of infection, such as:

  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered

There are also steps you can take to lower your risk of infection, such as:

  • Washing your hands often and reminding visitors and staff to do the same
  • Reminding staff to wear gloves or masks
  • Not letting others touch your incision
At Home

Recovery may take 4 to 6 weeks. Physical activity will be limited during this time. You will need to ask for help with daily activities and delay return to work.

Call Your Doctor

Call your doctor if you are not getting better or you have:

  • Signs of infection, such as fever and chills
  • Redness, swelling, excessive bleeding, or discharge at the incision site
  • Lasting nausea or vomiting
  • Pain that you cannot control with medicine
  • Problems breathing
  • Coughing up mucus that is yellow, green, or bloody

If you think you have an emergency, call for medical help right away.

RESOURCES

American Thoracic Society  http://patients.thoracic.org 

The Society of Thoracic Surgeons  http://www.sts.org 

CANADIAN RESOURCES

Canadian Society for Vascular Surgery  http://canadianvascular.ca 

The Lung Association  http://www.lung.ca 

References

Hemothorax. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/hemothorax. Accessed January 13, 2021.

Raveglia F, Scarci M. J Thorac Dis. 2019 Mar; 11(3): 370–375.Ultimate management of post thoracotomy morbidities: a set of surgical technique and peri-operative precautions.

Thoracotomy. American Lung Association website. Available at: https://www.lung.org/lung-health-diseases/lung-procedures-and-tests/thoracotomy. Accessed January 13, 2021.

Revision Information

  • Reviewer: EBSCO Medical Review Board Marcin Chwistek, MD
  • Review Date: 02/2020
  • Update Date: 01/13/2021