32506 Thoracotomy; with therapeutic wedge resection (eg, mass or nodule), each additional resection, ipsilateral (List separately in addition to code for primary procedure)

Name of the Procedure:

Thoracotomy with Therapeutic Wedge Resection (e.g., mass or nodule), Each Additional Resection, Ipsilateral

Summary

A thoracotomy with therapeutic wedge resection is a surgical procedure performed to remove abnormal tissue, such as a mass or nodule, from the lung. If multiple sections need to be removed from the same side of the chest, additional resections are performed.

Purpose

This procedure is used to address conditions like lung cancer, benign lung nodules, or other pulmonary pathologies. The main goal is to remove diseased or suspicious tissue to improve lung function or to diagnose the condition further.

Indications

• Presence of a lung mass or nodule deemed suspicious by imaging studies.
• Medical necessity determined by biopsy results.
• Pulmonary infections or inflammatory conditions not resolved by other treatments.
• Patients typically eligible are those with localized lung lesions who are considered fit for surgical intervention.

Preparation

• The patient may be required to fast for a certain period before surgery.
• Pre-operative assessments include blood tests, imaging studies (CT scan, X-rays), and pulmonary function tests.
• Medication adjustments may be necessary, especially concerning blood thinners or other relevant drugs.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made in the chest (thoracotomy) to access the lung.
3. The surgeon uses specialized surgical instruments to remove the targeted lung tissue in a wedge shape.
4. Additional resection involves carefully excising any other suspicious areas within the same lung.
5. The lung and chest wall are then closed, and drainage tubes might be placed to remove excess fluids.

Duration

The procedure typically takes between 2 to 4 hours, depending on the complexity and number of resections required.

Setting

The procedure is generally performed in a hospital setting, specifically in an operating room.

Personnel

• Thoracic surgeon
• Surgical nurses
• Anesthesiologist
• Operating room technicians

Risks and Complications

• Bleeding and infection
• Air leaks from the lung
• Pneumonia or other respiratory complications
• Adverse reactions to anesthesia
• Prolonged pain or numbness in the chest area

Benefits

• Effective removal of abnormal lung tissue, potentially improving overall lung function.
• Offers a diagnostic advantage if the cause of the lesion is unknown.
• Early removal of cancerous growths can increase the chances of a cure.

Recovery

• Hospital stay of about 3 to 7 days post-procedure.
• Post-operative care includes pain management, breathing exercises, and chest physiotherapy.
• Recovery at home may take several weeks. Patients are usually advised to avoid heavy lifting and strenuous activities during this period.
• Follow-up appointments are necessary to monitor recovery and lung function.

Alternatives

• Non-surgical treatments like chemotherapy, radiation therapy, or targeted drug therapy.
• Less invasive procedures like bronchoscopic interventions.
• Pros and cons: Non-surgical measures may have fewer immediate risks but might not provide a definitive diagnosis or removal of the entire lesion.

Patient Experience

• The patient will be under general anesthesia during the procedure, so they will not feel anything.
• Post-operative discomfort or pain is managed with medications.
• Patients might experience some soreness, difficulty breathing, or fatigue, which gradually improves over a few weeks.
• Emotional support and reassurance throughout the recovery process can help in coping with the surgery and ensuring a smoother recovery.