Sometimes when a doctor tells you or someone in your family that you need to have chest surgery, they may also mention the word "thoracotomy." It's normal to feel a little scared and nervous when you hear this word. "What kind of surgery is it?", "Is it dangerous?", "Will it hurt a lot?" are all questions that come to mind. So today, let's talk about what this thoracotomy surgery really is, what reasons it's done for, and everything you need to know about it.
What exactly is Thoracotomy?
Simply put, a thoracotomy is a cut that a surgeon makes between two ribs to see or treat the organs inside your chest. Think of it like opening the cover of a book to see the pages, the surgeon has to open the chest to reach the organs inside the chest.
The main organs that can be seen when the chest is opened in this way are:
- Lungs
- The heart and its associated large blood vessels (for example, the aorta)
- Esophagus
- Trachea
Sometimes this method is used to reach the front of the spine. This incision is usually made on the left or right side of the chest. This depends on the side of the organ being treated. The incision starts at the chest and goes down to the back under the armpit. The size and location of the incision vary depending on the type of surgery being performed. Sometimes, the surgeon may have to break or remove a rib. This is also called 'open surgery' .
Why do we need to perform a thoracotomy?
There are several reasons why a thoracotomy may be performed. Sometimes it is done to obtain a tissue sample (biopsy) to diagnose a disease. Other times, it is done as a treatment for a disease. Let's look at the main reasons for this surgery.
| Reason for surgery | A simple explanation |
|---|---|
| A biopsy | If there is a suspicion of a lung condition, a tissue sample can be obtained to definitively identify it. |
| Lung Cancer | To remove cancerous tumors in the lungs or part of the lung. |
| Cardiovascular Conditions | To treat certain problems in the heart or large blood vessels connected to the heart. |
| Collapsed Lung | To treat cases of collapsed lungs, medically known as pneumothorax . |
| Fluid accumulation around the lungs/heart | To treat pleural effusion or cardiac tamponade , especially when caused by infection. |
| Esophageal Diseases | To treat cancer or other diseases of the esophagus. |
What happens before the surgery?
This is a major operation and you will need to be under general anesthesia. So you need to be healthy enough to tolerate this type of anesthesia. The medical team will advise you on when to stop eating and drinking before the operation.
Very important: It is imperative that you tell your doctor about every medication, vitamin, or supplement you are taking, even those you can buy over-the-counter. Some medications, especially blood thinners, may require you to stop taking them a few days before surgery. Follow these instructions carefully.
Unless it's an emergency surgery, doctors will definitely tell you to quit smoking . It helps a lot with the healing process.
What happens during the surgery?
During the surgery, the medical team will turn you to one side and place you in a comfortable position with one arm above your head.
The anesthesiologist who will anesthetize you during this surgery is a specialist in chest surgery. He will control your breathing so that only one lung is working (single lung ventilation) . This means that the lung on the side of the operation is temporarily turned off and you are allowed to breathe only from the other lung. This makes it much easier for the surgeon to perform the operation.
The surgeon then makes an incision between the two ribs, uses special instruments (retractors) to widen the incision, and examines the internal organs or performs the necessary treatment.
After the surgery is over and the incision is closed, a chest tube is inserted to drain any fluid and air that has accumulated inside. This is like a tube.
What happens after the surgery and how long does it take to recover?
After the surgery, you will need to stay in the hospital for about a week. The chest tube will remain in place for a few days. During this time, the medical team will give you medication to control your pain.
Your contribution is also very important in the healing process.
- The medical team will encourage you to cough and breathe deeply .
- They recommend using a device called an 'incentive spirometer' for breathing exercises.
- He asks to walk a little with help.
Although these things may be a little difficult at first, they are essential to prevent lung infections (like pneumonia).
After you go home from the hospital, it can take up to two months to fully recover and resume normal activities. Ask your doctor when you can resume activities such as lifting weights and playing sports.
What are the risks of this surgery?
Like any surgery, Thoracotomy surgery carries some risks. Don't worry, the medical team will do their best to minimize these risks.
- Common risks associated with surgery: problems with anesthesia, infection, bleeding, and pain.
- Possible complications later:
- Pneumonia: A lung infection.
- Atelectasis: Collapse or collapse of parts of the lung.
- Post-thoracotomy pain syndrome: Pain that persists for months after surgery.
When do you want to see the doctor again?
After you leave the hospital, you will be informed about the days you need to return to the clinic. However, if you develop any of the following symptoms, you should call your doctor immediately .
- If you get a fever.
- If the cut starts bleeding again or if blood comes out when you cough.
- If you have difficulty breathing.
- If the incision site is oozing pus, swollen, red, or discolored.
- If you can't control the pain even after taking medication.
If you have an emergency, such as severe difficulty breathing or heavy bleeding, go to the nearest hospital's Emergency Department (ETU) immediately .
Take-Home Message
- Thoracotomy is a major surgery performed to treat the organs in the chest. Although it is normal to feel scared about it, it can be a necessary and life-saving procedure. (The previous sentence had a Tamil phrase by mistake. Correcting it to pure Sinhala as per instructions.) However, it can be a life-saving and necessary procedure.
- Follow the doctor's instructions carefully before surgery, especially regarding quitting smoking and informing him about the medications he is taking.
- Post-surgery pain management and deep breathing exercises are very important for a speedy recovery and to prevent complications such as pneumonia.
- If any problems or dangerous symptoms arise during the recovery period, inform your doctor immediately.
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