Thoracotomy; for postoperative complications
CPT4 code
Name of Procedure:
Thoracotomy
(Common names: Open chest surgery, Surgical chest incision)
Summary
A thoracotomy is a surgical procedure involving an incision into the chest wall to access organs within the thoracic cavity, such as the lungs, heart, esophagus, or great vessels.
Purpose
Thoracotomy is performed to diagnose or treat conditions related to the thoracic organs. Goals include the removal of diseased tissue, biopsy for diagnosis, repair of injuries, or the installation of medical devices.
Indications
- Lung cancer or tumors
- Severe chest trauma
- Infections like empyema
- Heart and lung transplantation
- Esophageal surgery
- Persistent pneumothorax (collapsed lung)
Preparation
- Pre-procedure fasting (usually starting midnight before surgery)
- Medication adjustments (such as stopping blood thinners)
- Diagnostic tests including chest X-rays, CT scans, EKG, and blood work
- Preoperative assessment by a cardiologist or pulmonologist if necessary
Procedure Description
- The patient is put under general anesthesia.
- A surgical incision is made typically between the ribs on the side of the chest.
- The ribs may be spread apart to access the thoracic cavity.
- The surgeon performs the necessary actions (e.g., removing a tumor).
- Chest tubes may be inserted to drain fluids or air post-operation.
- The incision is closed with sutures or staples.
Duration
The procedure usually lasts between 2 to 6 hours, depending on its complexity.
Setting
Thoracotomies are performed in hospital surgical suites.
Personnel
- Thoracic surgeons
- Anesthesiologists
- Surgical nurses
- Possibly other specialized healthcare providers depending on the case
Risks and Complications
- Infection
- Bleeding
- Air leaks from the lungs
- Pain at the incision site
- Pneumonia
- Prolonged ventilator support or respiratory issues
- Blood clots
Benefits
- Removal of diseased tissues or tumors
- Relief from symptoms and improved organ function
- Accurate diagnosis from biopsies
- Restored function and structure from repairs
Recovery
- Hospital stay duration varies from 5 to 10 days
- Pain management with medications
- Instructions on deep breathing exercises to prevent pneumonia
- Limited physical activity for several weeks
- Follow-up appointments for wound check and to monitor recovery
Alternatives
- Minimally invasive surgeries like Video-Assisted Thoracoscopic Surgery (VATS)
- Radiation therapy for certain cancers
- Chemotherapy
Conservative management with medications and therapy
Patient Experience
Patients may experience significant pain post-surgery requiring pain management strategies. They will feel drowsy and might have chest drains in place which could be uncomfortable. Breathing exercises and physical therapy are crucial for recovery. Fatigue and discomfort are common, and emotional support can aid recovery.