Name of the Procedure:

Thoracotomy with diagnostic biopsy(ies) of lung infiltrate(s) (e.g., wedge, incisional), unilateral

Summary

A thoracotomy with a diagnostic biopsy involves surgically opening the chest to remove a small piece of lung tissue for examination. This procedure helps diagnose abnormalities or lesions in one lung.

Purpose

The primary goal is to identify and diagnose lung infiltrates, which can include infections, inflammatory conditions, or malignancies. It helps determine the precise cause of lung abnormalities, guiding further treatment.

Indications

• Persistent or unexplained lung infiltrates detected on imaging
• Suspicion of lung cancer, tuberculosis, or other infections
• Non-responsive to standard treatments Patients with abnormal lung findings that require tissue sampling for a definitive diagnosis.

Preparation

• Patients may need to fast for 8 hours before the procedure.
• Specific medication adjustments (e.g., blood thinners may need to be stopped).
• Pre-procedure tests might include blood work, chest X-rays, CT scans, and pulmonary function tests.

Procedure Description

1. The patient is placed under general anesthesia.
2. An incision is made on one side of the chest to access the lung.
3. Part of the lung tissue is removed using either a wedge resection (small piece) or an incisional biopsy.
4. The removed tissue is sent to pathology for analysis.
5. The incision is closed with sutures or staples. Tools include scalpels, forceps, and possibly video-assisted thoracoscopy (VATS) equipment.

Duration

The procedure typically takes 2-3 hours.

Setting

Performed in a hospital's surgical suite.

Personnel

• Thoracic surgeon
• Anesthesiologist
• Surgical nurses
• Pathologist (for tissue analysis)

Risks and Complications

• Infection
• Bleeding
• Pain at the incision site
• Pneumothorax (collapsed lung)
• Adverse reactions to anesthesia Rare risks include respiratory complications and arrhythmias.

Benefits

• Accurate diagnosis of lung infiltrates
• Helps in developing an effective treatment plan
• Can lead to early detection of serious conditions

Recovery

• Hospital stay for a few days to monitor lung function and recovery
• Pain management typically involves medications.
• Instructions on wound care and activity restrictions.
• Follow-up appointments to monitor healing and discuss biopsy results. Complete recovery may take several weeks.

Alternatives

• Needle biopsy (less invasive but might not provide enough tissue)
• Bronchoscopy (less invasive but not always suitable) Pros of thoracotomy: Comprehensive tissue sampling. Cons: More invasive with longer recovery.

Patient Experience

• Under anesthesia during the procedure, so no pain is felt.
• Post-procedure discomfort managed with medications.
• Some patients may experience temporary difficulty breathing. Pain management is crucial for comfort during recovery.