Name of the Procedure:

Thoracotomy, with diagnostic biopsy(ies) of lung nodule(s) or mass(es) (e.g., wedge, incisional), unilateral

Summary

A thoracotomy is a surgical procedure that involves making an incision in the chest wall to gain access to the lungs for diagnostic purposes. This procedure is used to obtain a tissue sample (biopsy) from a lung nodule or mass to determine if it is malignant or benign. The biopsy can be performed using various techniques, such as wedge or incisional biopsy, and is typically done on one side of the chest (unilateral).

Purpose

Thoracotomy with biopsy is used to diagnose lung nodules or masses.

• Medical Conditions Addressed: Lung cancer, infections, inflammatory conditions, and other lung diseases.
• Goals: To obtain a tissue sample for microscopic examination to identify the nature of the nodule or mass and guide further treatment.

Indications

• Presence of lung nodules or masses identified through imaging tests (e.g., X-ray, CT scan).
• Persistent symptoms such as unexplained cough, weight loss, or breathing difficulties.
• Clinical suspicion of lung cancer or other serious lung diseases.

Preparation

• Fasting: Patients may need to fast for 8-12 hours before the procedure.
• Medication Adjustments: Certain medications, especially blood thinners, may need to be adjusted.
• Pre-Procedure Tests: Blood tests, imaging studies, pulmonary function tests, and electrocardiogram (ECG) may be required.

Procedure Description

1. The patient is given general anesthesia to ensure they are unconscious and pain-free during the procedure.
2. A surgical incision is made in the chest wall to access the lungs.
3. The surgeon locates the lung nodule or mass.
4. A wedge or incisional biopsy is performed to obtain a tissue sample.
5. The tissue sample is sent to a pathology lab for analysis.
6. The incision is closed with sutures or staples, and a chest tube may be placed to drain any excess fluid or air.

Tools and Equipment: Scalpel, surgical retractors, biopsy instruments (e.g., forceps, wedge cutter), chest tube.

Duration

The procedure typically takes 1-3 hours, depending on the complexity.

Setting

Thoracotomy with biopsy is performed in a hospital operating room.

Personnel

• Surgeons specialized in thoracic surgery
• Anesthesiologists
• Surgical nurses
• Pathologists (for analyzing the biopsy)

Risks and Complications

• Common Risks: Pain, infection, bleeding, and temporary difficulty breathing.
• Rare Risks: Persistent air leak, pneumothorax (collapsed lung), damage to nearby organs, and adverse reactions to anesthesia.

Benefits

• Provides a definitive diagnosis of the lung nodule or mass.
• Helps in the early detection of lung cancer or other serious conditions.
• Guides appropriate treatment plans.

Recovery

• Post-Procedure Care: Pain management, monitoring for signs of complications, and care of the surgical incision.
• Recovery Time: Varies, but typically a few weeks. Patients may need to stay in the hospital for a few days.
• Restrictions: Limited physical activity and lifting, follow-up appointments for suture removal and assessment.

Alternatives

• Non-Surgical Options: Needle biopsy (less invasive but may not provide as comprehensive a sample).
• Pros and Cons: Needle biopsy is less invasive with a shorter recovery time but may be less definitive. Thoracotomy provides a more comprehensive tissue sample but is more invasive with a longer recovery.

Patient Experience

• During the Procedure: The patient will be unconscious due to general anesthesia.
• After the Procedure: Patients may experience pain and discomfort at the incision site, which can be managed with analgesics. They may have a chest tube for a few days and will need to avoid strenuous activities during recovery. Regular follow-up will be necessary to monitor recovery and receive biopsy results.