To manage pleural mesothelioma, doctors use the two most effective treatment options available: pleurectomy decortications and extrapleural pneumonectomy. A thoracotomy will be performed before either of these surgical procedures. Thoracotomy surgeons have found that more than 25 percent of mesothelioma patients have an inoperable condition after examining their lungs. When that happens, doctors will instead determine the stage of a patient’s cancer.
A thoracotomy may be needed prior to several different types of surgeries that help treat mesothelioma and asbestos-related lung cancer. To provide the optimum results and to craft the most effective treatment plan, doctors need direct access to the lungs that a thoracotomy provides. Doctors can then determine type of cancer, stage of cancer, and also see if any visible tumors can be removed.
Surgeries that require a thoracotomy first include: pleurectomy/decortication, extrapleural pneumonectomy, wedge resection, segmentectomy, lobectomy, pneumonectomy.
The Thoracotomy Procedure
Before the surgery takes place, many tests are performed to evaluate several health factors that could affect the procedure. Patients will need a physical exam, chest X-ray, MRI or CT scan, urine test and blood work. It is vital for doctors to know the present function of a patient’s lungs and heart.
The procedure itself requires only general anesthesia, after which the doctor will have a patient lay on their side and raise their arm. The surgeon will make an incision along the upper back area, under the arm, in order to have access to a patient’s lungs. The surgeon also may spread the ribs and muscles and open the chest wall.
Temporary tubes will be inserted in the chest after the procedure is completed. This will permit blood, air, and any other fluids to drain from the chest area as the healing takes place. The tubes will remain in place for several days post-operation. Before patients are moved to a regular hospital room, most will recover for several days in ICU. The total recovery period can range from five to 10 days.
Recovering from a Thoracotomy
Near the incision site, there may be some irritation to nerve endings. Therefore, patients have reported having pain, numbness or burning below the breast and at the front of the rib cage.
The medical professionals assigned to a patient will take the time to show how to care for the incision wound. Patients should understand that the incision should never be submerged in any spa or bathtubs for at least three weeks after surgery. In the shower, a mild soap and gentle wash will be enough to keep the incision site free from infection. Drainage of a clear or pink fluid from the incision is typical.
A doctor and medical team will give provide specific instructions for maximum home recovery care. In addition to wound care and cleaning, pain management will be directed. Patients should avoid lifting items that are heavy, and any activity that could put added stress on the incision should also be avoided. To improve lung capacity after surgery, daily walking and breathing exercises will aid in circulation and assist in recovery. Doctors should be notified of any follow-up questions or concerns should they arise.