> Mesothelioma Treatment > Surgery > Thoracotomy

Thoracotomy

While many pleural mesothelioma patients are treated with therapies such as radiation or chemotherapy, a select few are candidates for surgery. Most surgeries for mesothelioma are serious and require long recovery periods. They are best performed on patients who are in the early stages of development. A thoracotomy may be the first step in many chest area surgeries used to treat pleural mesothelioma patients.

What is a Thoracotomy?

A thoracotomy is not a surgery. Rather, it is the name that refers to the incision that is made in order to gain access to the thoracic organs, namely the lungs, heart, esophagus and thoracic aorta. The incision is made into the pleural space of the chest and this procedure may be used before a pneumonectomy or extrapleural pneumonectomy is performed.

This incision is made under general anesthesia and necessitates the insertion of an endotracheal tube while the patient is put on mechanical ventilation. It is noted by most surgeons that the thoracotomy is one of the most difficult incisions to handle post-operative because it is very painful and the pain often restricts normal breathing, sometimes resulting in conditions such as pneumonia.

What to Expect During a Thoracotomy

After the patient is prepped for surgery, anesthesia is given and the procedure begins. The incision for thoracotomy happens on the side of the chest between two ribs. The ribs are then spread apart so that the doctor can have easier access to the thoracic organs. Once the surgery is complete – whether it’s a pneumonectomy, lobectomy, or wedge resection – the incision will be closed up and bandaged.

However, chest tubes will remain in place to drain any blood or fluid that is associated with the surgery. The tubes will extend through small cuts and will be connected to a suction machine that will assist in the draining procedure. They will generally be in place for a few days or until all fluid is deemed removed. Other chest tubes may be placed in order to help the lungs refill with air after the surgery.

Time spent in the hospital will depend on the draining of the fluid and the presence of any surgical complications. These complications could include infection, bleeding, an open air leak in the lungs, heart or lung damage, and ongoing pain in the chest wall.

Generally after surgery that involves a thoracotomy, patients remain in the hospital for one to two weeks. They will be visited regularly by a respiratory therapist who will perform exercises with the patient to help him/her improve their lung function.

As previously mentioned, a thoracotomy can be a painful incision and many people complain about the pain even months after the surgery is complete. Any severe problems should be immediately reported to the patient’s surgeon for further exploration.  

Sources:

1. http://www.webmd.com/lung-cancer/lung-surgery-thoracotomy-for-lung-cancer