When a surgeon needs to gain access to a patient's lungs, heart, or other thoracic organs, he or she will perform a thoracotomy. For the purpose of this article, we'll focus primarily on the procedure in the context of a surgeon performing the procedure due to lung cancer. Typically, an incision is made into the patient's chest from the side, usually through the ribs. Then, the entire lung - or a portion of it - is extracted through the incision.
Below, we'll provide an overview regarding the three different strategies for performing a thoracotomy and when those approaches are commonly used. We'll also describe possible complications from the procedure as well as what you can expect post-op.
3 Different Approaches
If the cancerous cells only affect a small portion of the tissue, a surgeon will likely suggest a segmentectomy. When this method is used, only a small slice of one of the lobes is removed. That slice will contain the cancerous tissue as well as a small perimeter of good tissue.
Sometimes, a physician will suggest performing a lobectomy. Rather than simply removing a small slice of the lobe, the entire lobe is extracted. This is often done in order to prevent the cancer from returning.
On rare occasions, a pneumonectomy is performed. During this procedure, the surgical team will remove the patient's entire lung. The reason this method is rarely used is because the patient will suffer significantly diminished breathing capacity.
The criteria that determines which approach a surgeon will recommend includes the progress the cancer can made throughout the lung and the likelihood that cancerous cells will recur.
Possible Complications
A thoracotomy is a difficult operation and a number of complications can develop as a result. Pneumonia and infection can set in, bleeding can occur, and an air leak in the wall of the affected lung can develop. In rare cases, respiratory failure can follow surgery.
After The Procedure
Patients who undergo a thoracotomy can expect substantial pain after the surgery has been performed. Once the incision has been made in the side of the chest, the patient's ribs must be spread apart. What's more, a portion of a rib may need to be cut out in order to allow removal of the affected tissue. It's not uncommon to experience pain several months after a thoracotomy has been performed.
Patients should also expect to cope with chest tubes for several days in post-op. After surgery has been completed, fluid and blood will be present within the chest cavity. The tubes provide drainage. They also help the patient's lungs expand with air. Finally, a specialist will normally work with the person in order to improve their breathing function and strength.
A thoracotomy is an effective surgical procedure for removing cancerous cells. However, it is not to be taken lightly. Post-op recovery and rehabilitation can last for several weeks.
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