Lung Surgery (Thoracotomy) for Lung Cancer
Surgery to remove all or part of a lung involves making a cut on one side of your chest (thorax) during a procedure called a thoracotomy. Surgery that uses this approach avoids areas in the chest that contain the heart and the spinal cord.
After the cut is made between the ribs, all or part of the lung is removed depending on the location, size, and type of lung cancer that is present. See pictures of:
A video-assisted thoracoscopic surgery (VATS) may be done before or instead of a thoracotomy. This procedure involves inserting a long, thin tube (videoscope) with a camera attached and small surgical instruments into your chest through small cuts made between your ribs. The VATS method may be used to:
What To Expect After Surgery
Lung surgery requires you to stay in the hospital after the procedure. How long you stay will depend on:
Thoracotomy surgery involves making a cut in the side of your chest between your ribs. Your ribs are spread apart so that your surgeon can see into your chest cavity. A small piece of rib may also be removed to make it easier for the surgeon to take out the lung cancer. The incisions and your chest area may be painful for several weeks to months after surgery.
One or more chest tubes are used after surgery to drain your chest cavity of fluid and blood, which are present after lung surgery. The chest tubes also help your lungs refill with air. Chest tubes are placed in your chest cavity and extend out through your chest wall and skin through small cuts between your ribs on the same side as the surgery. The tubes are connected to a machine that creates a gentle suction, which helps your chest fluid to drain. The fluid is collected in a container that measures the amount of fluid draining from your chest. The chest tubes will be removed when the drainage from your chest has stopped and no air is leaking from your chest incision, which is usually after a few days.
A respiratory therapist will help you with breathing treatments to improve your lung function after surgery. Treatments usually involve deep breathing and the use of a spirometer. Medications may also be used to help open your airway and help you breathe more easily.
Why It Is Done
A thoracotomy with or without a videoscope is done to:
How Well It Works
Surgery is more effective in early-stage non–small cell lung cancer when the lung cancer can be completely removed and the cancer has not spread to lymph nodes or outside the chest cavity.
Surgery is sometimes used in limited-stage small cell lung cancer, when there is a single tumor and the cancer has not spread to the lymph nodes. But small cell lung cancers are not often diagnosed at this early stage.
Lung surgery risks include:
What To Think About
Lung surgery is most effective for early-stage lung cancers, especially non–small cell lung cancer.
Lung function tests, possibly including a lung scan, are usually done before surgery is considered. You may not be a good candidate for surgery to remove all or part of a lung if you have poor lung function. (For more information, see the topics Lung Function Test and Lung Scan.) Cardiac studies may also be done if you have any risk factors for complications from heart problems.
Lung surgery may be done to confirm a diagnosis of lung cancer. Additional surgery, such as removing the affected lobe (lobectomy) or lymph node biopsies, may be done at the same time for treatment purposes.
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