A thoracotomy is a surgery to open the chest wall. The surgery allows access to the lungs, aorta, heart, diaphragm, and spine. Depending on the disease location, a thoracotomy may be done in the center or on the right or left side of the chest.
A thoracotomy may be done to:
If you are planning to have a thoracotomy, your doctor will review a list of possible complications, which may include:
Factors that may increase the risk of complications include:
Your doctor may perform:
Leading up to surgery:
General anesthesia will be given. You will be asleep during the surgery.
You will be placed on your side with your arm elevated. An incision will be made between two ribs, from front to back. The chest wall will then be opened. In some cases, the doctor may take a different approach. The doctor can then do whatever procedure needs to be done in the open chest. When the procedure is done, one or more chest tubes will be placed. The tubes will make sure that blood or air does not collect in the chest. The chest wall will be closed. The incision is closed with stitches or staples and bandaged to prevent infection.
Drainage Tubes and Incision After Thoracotomy
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You will be sent to the intensive care unit for recovery. You will be monitored closely.
3-4 hours or longer
Anesthesia prevents pain during the procedure. You will have some discomfort after the surgery. Your doctor will give you medicine to help you manage the pain.
For some, a thoracotomy can lead to a chronic pain syndrome. It is usually described as burning pain in the area of surgery. It may be associated with increased sensitivity to touch in this area. It usually lessens over time, but you may need to see a pain specialist if the pain persists.
The usual length of stay is 5-10 days. Your doctor may choose to keep you longer if complications arise.
When you return home, do the following to help ensure a smooth recovery:
After you leave the hospital, call your doctor if any of the following occur:
In case of an emergency, call for medical help right away.
American Thoracic Society
The Society of Thoracic Surgeons
Canadian Society for Vascular Surgery
The Lung Association
Athanassiadi K, Kakaris S, Theakos N, Skottis I. Muscle-sparing versus posterolateral thoracotomy: a prospective study. Eur J Cardiothorac Surg . 2007;31:496-500.
Levy MH, Chwistek M, Mehta RS. Management of chronic pain in cancer survivors. Cancer J . 2008 Nov-Dec; 14(6):401-409.
Ohbuchi T, Morikawa T, Takeuchi E, Kato H. Lobectomy: video-assisted thoracic surgery versus posterolateral thoracotomy. Jpn J Thorac Cardiovasc Surg . 1998 Jun;46(6):519-22.
Video-assisted thoracoscopic surgery (VATS). University of Southern California, Cardiothoracic Surgery website. Available at: http://www.cts.usc.edu/videoassistedthoracoscopicsurgery.html. Accessed May 22, 2013.
Wildgaard K, Ravn J, Kehlet H.Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg . 2009 Jul;36(1):170-180. Review.
Last reviewed February 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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