A thoracotomy is a type of surgery used to access the lungs, heart, trachea or diaphragm. It is performed to confirm a diagnosis of mesothelioma or to remove cancerous areas. Mesothelioma is an aggressive cancer often caused by exposure to asbestos, a substance once used in the manufacture of fireproof building materials.
A thoracotomy is performed by making a cut in the side of the chest between the ribs. The ribs are then spread apart to allow the surgeon to see inside the chest cavity. In cases of mesothelioma, the surgery avoids the areas of the chest that contain the heart and spinal cord.
Types of Thoracotomy Surgeries
Segmentectomy – This is the best option in cases where the cancer is contained in the lungs and has not spread elsewhere. It is the least complicated surgery and leaves most of the lung intact which results in greater lung function. The main risk in this type of surgery is that the cancer has a greater chance of recurring. The surgeon will remove a wedge-shaped piece of lung which will be sent for a biopsy. A pathologist will then analyze the edges of the piece to determine if the cancer has spread. If the edges are free of cancerous cells, it is referred to as having “negative margins” and means the cancerous cells have been removed.
Lobectomy – In a lobectomy an entire lobe is removed from the lung. Every set of lungs has five lobes and the patient’s lungs will function normally with the remaining lobes. This option is used only when the cancer is contained in a single lobe of the lungs. It involves more risk, but is a good option if a segmentectomy has not proved successful.
Pneumonectomy – This is the most dangerous and risky of the three surgeries because an entire lung is removed. This is only performed on patients whose cancer is contained in the lung and has not spread to other areas. Some lining of the lungs may also be removed. A respirator may be used for a few days after surgery. Complete lung function will not be regained with this type of surgery.
All three types of thoracotomy require a chest tube to drain any excess fluid buildup after surgery. The chest tube may stay in place for a few days. Recovery time ranges from two to three months.