Thoracotomy

What Is a Thoracotomy?

A thoracotomy is a surgical procedure in which a cut is made between the ribs to see and reach the lungs or other organs in the chest or thorax. Typically, a thoracotomy is performed on the right or left side of the chest. An incision on the front of the chest through the breast bone can also be used, but is rare. A thoracotomy is performed for diagnosis or treatment of a disease and allows doctors to visualize, biopsy or remove tissue as needed.

What to Expect

A thoracotomy is performed under general anesthesia. An epidural catheter may be inserted in the mid-back before surgery for pain management. Once asleep, a breathing tube is placed into the airway to allow each lung to be separately inflated during surgery. You are then positioned on your side. An approximate six-inch incision is made below the tip of the shoulder blade, typically between the fifth and sixth ribs. During the surgery, the doctors will insert a chest tube on the side of the thoracotomy, which drains excess fluid or air leaking into the chest and helps your lungs to re-inflate. This tube remains in place for a few days.

After the procedure, you can expect some pain when taking a deep breath and will be prescribed pain medication. Your care team will have you use an incentive spirometer for breathing exercises to help prevent pneumonia while you recover. They may also instruct you on how to splint your chest for deep breathing and coughing.

Understanding the Results

A thoracotomy may be performed for a variety of reasons, and the results dependent on the reason for the procedure. If a thoracotomy is performed to remove a mass, tissue will be sent to the lab for evaluation. Some results can take multiple days to finalize. Your care team will typically schedule a follow-up visit within two weeks to discuss your results.

What Are the Risks?

Immediate risks from the surgery include infection, bleeding, persistent air leakage from your lung and pain. Pain is the most commonly encountered complication of this procedure, and pain along the ribs and site of incision will most likely subside over days to weeks. However, a late thoracotomy risk is post-thoracotomy pain syndrome. This syndrome involves persistent chest pain related to nerve damage that continues months after undergoing a thoracotomy. Life-threatening injury from a thoracotomy is rare.