Thoracoscopy

Alternative names
Thoracotomy; Lung tissue removal; Pneumonectomy; Lobectomy; Lung biopsy; Lung surgery

Definition
Lung surgery is any surgical procedure that allows the surgeon to directly affect the lungs. Examples include removal of a section of lung because of a tumor or an infection, biopsy of the lung to obtain a diagnosis, and lung transplantation.

Description

While the patient is under general anesthesia, an incision is made between the ribs to expose the lung. The chest cavity will be examined and diseased lung tissue will be removed.

This examination may be performed directly (thoracotomy) or with the aid of a camera (thoracoscopy). A chest tube is inserted to drain air, fluid, and blood out of the chest cavity, and then the ribs and skin are closed.

Indications
Lung surgery may be recommended for the following reasons:

     
  • Cancer (such as lung cancer)  
  • Tumors (such as solitary pulmonary nodule)  
  • Small areas of long-term infection (such as highly localized pulmonary tuberculosis or mycobacterium)  
  • Pockets of infection (lung abscess)  
  • Permanently enlarged (dilated) airways (bronchiectasis)  
  • Permanently dilated section of lung (lobar emphysema)  
  • Permanently collapsed lung tissue (atelectasis)  
  • Injuries with collapsed lung tissue (atelectasis, pneumothorax, or hemothorax)

Risks
Risks for any anesthesia include the following:

     
  • Reactions to medications  
  • Problems breathing

Risks for any surgery include the following:

     
  • Bleeding  
  • Infection

Additional risks of lung surgery include the following:

     
  • Blood clots  
  • Pneumonia

Expectations after surgery
The outcome depends on the type and severity of the problem, but many patients recover nicely.

Convalescence

Hospital stay is usually 7 to 10 days. Deep breathing is important to help prevent pneumonia and infection and to re-expand the lung. The chest tube remains in place until the lung has fully expanded.

Pain is managed with medication. The patient usually recovers fully by 1 to 3 months after the operation.

Johns Hopkins patient information

Last revised: December 7, 2012
by Sharon M. Smith, M.D.

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