Understanding Thoracotomy

A thoracotomy is a surgical procedure where your doctor makes an approximate 6-7 inch incision from your upper back, under your arm, and around the side of your rib cage. The muscles and ribs are separated, exposing the lung to allow removal of part or all of a lung. This procedure requires general anesthesia and a hospital stay averaging 5-7 days. Your doctor may know the preliminary results of the procedure the same day. The final pathology report will take up to 3-5 working days and will be reviewed with you while you are in the hospital or when you return for a postoperative visit. 

How to Prepare for Your Procedure

Many medications, whether over-the-counter or prescription, can interfere with normal blood clotting and increase the risk of bleeding. Follow the guidelines in the chart below. If your doctor gives you different instructions, always follow your doctor’s instructions.

7 days before your procedure, STOP:

  • Aspirin
  • vitamins
  • herbal & garlic supplements
  • Plavix® (clopidogrel)

5 days before your procedure, STOP:

  • Coumadin® (warfarin)

3 days before your procedure, STOP:

All nonsteroidal antiinflammatory medications (NSAIDs):

  • Advil® or Motrin® (ibuprofen)
  • Aleve® or Anaprox® (naproxen)
  • Feldene® (piroxicam)
  • Clinoril® (sulindac)
  • Orudis® (ketoprofen)

2 days (48 hrs) before your procedure, STOP:

  • Fragmin® (dalteparin)
  • Arixtra® (fondaparinux)

1 day (24 hrs) before your procedure, STOP:

  • Lovenox® (enoxaparin)

DO NOT eat or drink after midnight the night before the surgery; this includes gum, candy, lollipops, water, coffee, juice, etc.

What to Expect On the Day of Your Procedure

  • On the morning of your surgery, take only the medications approved by your anesthesiologist, with a very small sip of water. If you are unsure of these medications please contact a nurse in the Thoracic Center for an explanation. • The morning of your surgery, check in at Patient Access (Registration) on the ground floor in the hospital lobby. You will then be directed to the surgical area, 3 West.
  • An intravenous catheter (IV) will be placed in a vein in your arm so that medications and fluids can be given to you for the procedure.
  • You will be taken to a “holding area” which is located just outside the operating room. The anesthesiologist will meet you there before you are taken into the operating room. Your family will not be able to join you in the holding area.

What You Can Expect After Your Procedure

  • You may be in the intensive care unit (ICU) for the first 24-48 hours. You will then be transferred to a general surgical floor.
  • In the ICU you will be attached to a cardiac monitor that shows your heart rate and rhythm, blood pressure and oxygenation level.
  • You will have a chest tube in your side for at least 24-72 hours, longer if necessary. Sometimes there is an “air leak” from the lung tissue that may delay removal of the chest tube. Your chest tube will be removed as soon as your lung has fully expanded and air does not leak from the lung.

When to Call Your Doctor

Call your doctor immediately if you have:

  • Increased shortness of breath or increased difficulty breathing
  • Chest pain
  • Fever of 100.5°F(38°C) or higher
  • Heart palpitations
  • Swelling of an extremity or leg pain
  • Increased redness or swelling of incisions
  • Pus-like or foul-smelling drainage from incisions
  • A bubbling or sucking sound from an incision
  • Constipation not resolved with stool softeners

Questions or Concerns

If you have any questions about your procedure, please call the Thoracic Center at (716) 845-1411. The Center is open Mon - Fri from 8:00 am to 4:30 pm. During evenings, weekends, and holidays, please call the main hospital at (716)-845-2300 and ask for the thoracic doctor on call.