This procedure is more extensive and involves your physician making a 6-10 inch incision from your upper back, under your arm, to around the front of your rib cage. The muscles and ribs are separated, exposing the lung, and allowing removal of part or all of the lung. A thoracotomy requires a hospital stay of five to seven days. You will have a chest tube, require pain medication, and possibly require a urinary catheter.

Preparation
You will come to the hospital the morning of the procedure. You may not eat or drink after midnight the night before. You will have an IV placed in your arm so that medications to put you to sleep can be given.

Advantages
Advantages to a thoracotomy include possible removal of the lung mass at the same time as the biopsy. Preliminary results of the biopsy will be known the same day. Final pathology takes three to five working days.

Possible Risks

• Bleeding
• Infection
• Chronic pain due to disruption of the nerves within the chest wall
• Shortness of breath

What to expect after the procedure
You will be in intensive care (ICU) for the first 24-48 hours, then you will be moved to the general surgery floor. You will have a chest tube in at least 48-72 hours, possibly longer if necessary. For pain management, an epidural pain catheter can be offered which will be put in during surgery and stay in for about three days. The epidural will require placement of a urinary catheter, which can be removed after the epidural pain catheter, is removed. The incision will be painful and will require pain medication management for one to two weeks, at a minimum. You will have an IV for three to five days and will require chest x-rays to monitor your lung.

WHAT TO REPORT TO YOUR PHYSICIAN

1. Increased shortness of breath
2. Chest pain
3. Fever more than 101 degrees
4. Heart palpitations
5. Swelling of an extremity, or leg pain