Thoracotomy- What Should You Know?

Thoracotomy- What Should You Know?

A thoracotomy is a special type of surgery that performed on the chest. It is a typical treatment for lung cancer. This article tells you about the general information on a thoracotomy and what measures to know while recovering from it.

What do you understand by thoracotomy?

A thoracotomy is a surgical process that is used in emergency situations. The surgeon will make an incision in the chest to access the lungs. The name thoracotomy is derived from “thorax” which is a word for chest. The organs that reside in the chest are called thoracic organs. These organs include the following.

  • Heart
  • Lungs
  • Esophagus
  • Diaphragm
  • Aorta

The thoracotomy is a process that opens access to these organs. It is also used to treat any problem of these organs. The most common reason to perform a thoracotomy is to treat lung cancer. Brief information on why to perform thoracotomy is as follows.

Thoracotomy for lung cancer treatment

Lung cancer is a leading type of cancer that is affecting lots of people. It is the second most prevailing type of cancer worldwide. The American Cancer Society has estimated that there will be approximately 234,030 new cases of lung cancer this year, only in the United States. The number of affected people is even higher globally.

Thoracotomy allows the doctor to open the chest and get direct access to the lungs. Lungs are the main area affected by lung cancer, so it is easy to perform any lung surgery this way.

Thoracotomy for removal of a rib

A rib or a part of the rib is removed surgically if there is a bone fracture. Some conditions such as bone cancer also require removing a part or complete rub if the bone is affected.

Performing thoracotomy opens the chest, which is an easy way to operate a person’s ribs, making the removal of rib possible.

Thoracotomy for resuscitation

Sometimes, a thoracotomy is helpful in an emergency chest injury. It allows the doctor to do the following.

  • It makes easy to control the bleeding that comes from the heart or thoracic blood vessels
  • It helps to carry out the compressions to pump blood
  • It relieves the pressure on the heart from any accumulated fluid

More than just surgery, a thoracotomy is a tool to save a dying person’s life, if performed with accuracy.

How to perform a Thoracotomy?

In a thoracotomy, different types of incisions are used. The choice of incision is based on the reason to perform surgery. Before the thoracotomy, the person is subjected to the general anesthetic.

They are also given an epidural that provides pain medicine to the spine. This protocol is necessary to make a person fall asleep. So that the thoracotomy is performed well and he is unable to feel any discomfort during the procedure.

To start the thoracotomy, the doctor makes an incision in the chest. There are many places where this incision can be made. The choice of this place depends upon the target organ, which the doctor wants to access.

A few types of thoracotomy, based on its location are as follows.

  • Axillary thoracotomy

In this type of procedure, the incision is made into the thorax from a side. This side is usually under the patient’s arm.

  • Median sternotomy

In this procedure, the incision is made into the thorax from the front side. This front side is where your breastbone is located.

  • Intercostal approach

This procedure uses an incision that is made between the ribs. It is to reduce the muscular, nerve and bone damage. This is the simplest form of thoracotomy.

  • “L shaped” thoracotomy

This type of thoracotomy is only performed on an emergency basis when a person reaches the hospital. The research says that this particular type of thoracotomy can be performed even with minimal equipment.

In this operation, a tube is passed down from the windpipe of the patient to access the lung. It is to enable the lung being operated on to be deflated. The other lung is kept inflated by the help of a mechanical device.

Once this setup is made, lung cancer treatment, rib removal, resuscitation or any other required treatment is performed. Though it sounds simple it needs extreme care and accuracy of the surgeon.

Complications of thoracotomy

There are so many risks and side effects that are linked with thoracotomy. Some of them are as follows.

Undesirable effects of anesthetic

As already mentioned, thoracotomy requires the person to be under general anesthesia. That is important so that they don’t wake up in the middle of the surgery and do not feel pain or discomfort while surgery is performed on them. But anesthesia sometimes causes side effects. It is necessary to meet and discuss the possible side effects with your doctor. The common side effects of anesthesia are

  • nausea
  • vomiting
  • dizziness
  • a headache
  • blood pressure
  • allergy

Possibility of hemorrhage

If the thoracotomy is not performed with skill, there are chances that excessive bleeding will cause a hemorrhage. There are so many tiny blood vessels in the lungs, if any of them is injured, it will cause bleeding during the procedure.

Risk of a blood clot

Sometimes there is also a possibility to develop a blood clot while thoracotomy is being performed on a patient. It mostly starts with the leg that is called deep vein thrombosis.

Although it is rare sometimes this clot travels to the lungs and causes pulmonary embolism that blocks the major artery of the lung.

Chance of a collapsed lung

In “L shaped” thoracotomy when the tube is removed from the chest, there is a risk that it will collapse the lung. It is medically called pneumothorax. This is the point where the air gets trapped between the lung and the chest wall, causing sharp pain.

The possibility of an infection

After the surgery, there is the possibility for some liquid to drain from the incision. It is necessary to keep the wound clean so that there is least risk of any bacterial infection to prevail.

Risk of pneumonia

There is a high risk of pneumonia after thoracotomy. Usually, it is helped by following deep breathing and coughing exercises that reduce the risk. The doctor also prescribes pain relief medicines after the surgery.

Paralysis

Although very rare, sometimes patients experience paraplegia after a thoracotomy.

The difference between thoracotomy vs. thoracostomy

You may confuse thoracotomy with thoracostomy but both these are two different procedures. A thoracotomy is an incision-based procedure that is performed in the chest. It enables a doctor to get access to the heart, lungs, or other structures in the chest. This is a common treatment for lung cancer.

On the other hand, a thoracostomy is a procedure that helps to remove excess fluid, blood, or air. A thoracostomy is performed in following situations.

  • In the case of a lung infection (pneumonia)
  • In case of a chest injury that is causing bleeding
  • In case of an infection in the pleural space between the lungs and chest wall
  • When the fluid buildup due to cancer or chest surgery

Recovery from thoracotomy

The recovery from thoracotomy is speedy if followed by the doctor’s advice. The outlook depends on the reason why thoracotomy was performed on him. If it is due to lung cancer, the stage of lung cancer estimates the patient’s health and recovery.

The incision and wound of thoracotomy are healed completely within 2 months maximum. In this time pain, discomfort and post-surgical stress are completely gone. Sometimes the nerve damage takes place during the surgery that causes ongoing pain and is called post-thoracotomy pain syndrome.

In case of an unreasonable pain, side effects or discomfort after the surgery, speak to your doctor as soon as possible and explain the condition.

 

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The author is a Medical Microbiologist and healthcare writer. She is a post-graduate of Medical Microbiology and Immunology. She covers all content on health and wellness including weight loss, nutrition, and general health. Twitter @Areeba94789300

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