Mesothelioma Treatment - Surgery - Thoracotomy

Thoracotomy is a general term referring to a type of surgery used to access the lungs, heart, aorta, trachea, or diaphragm, and may be performed on either side of the chest.

There are three main types of lung surgery. If the mesothelioma cancer has not yet spread and is confined to a single area of the lungs, the best thoracotomy option is a segmentectomy. Also know as wedge resection, this surgery is the least dangerous and still leaves the patient with most of the affected lung intact. In this surgery a doctor removes a small slice of the lung, usually in a wedge shape, where the cancer is localized.

The removed portion of the lung will be sent to biopsy. A pathologist then analyzes the tissue to determine if the edges of the removed portion are free of cancer (indicating the cancer has not spread). Edges that are free of cancerous characteristics are referred to as "negative margins," which typically suggests the cancer has been removed completely.

The main risk associated with this technique is that the cancer is more likely to return with this surgery. Conversely, this procedure is less risky than others because it is a less complicated surgery, and it also results in greater lung function than other procedures.

The second kind of lung surgery is called a lobectomy. In every set of lungs, there are five lobes - three on the right and two on the left. During a lobectomy, an entire lobe is removed. This technique can be used if the cancer is contained in a single lobe. It involves more risk, but can be the best option if a wedge resection is not adequate.

The third type of thoracotomy is the pneumonectomy. This procedure is by far the most dangerous because it involves the removal of an entire lung and it is only applicable to mesothelioma patients whose cancer has not spread beyond the lungs. The surgery begins with the collapsing of the lung slated for removal. The airway leading to that lung is clamped, cut, and tied off. All blood vessels leading to that lung are tied off to prevent leaking. The lung is then carefully and completely removed. Some of the lung's lining may be removed as well. This is a good option if the cancer has spread over the lung but has not yet spread to other parts of the body. After surgery, patients must use a respirator for at least a few days and will never regain total lung function.

Following each of these types of surgery, a chest tube will remain to drain fluid and blood. This tube may need to stay in place for a few days. The procedures usually require a hospital stay of approximately two weeks and a recovery time of two to three months.

Sources:

Web MD, http://www.webmd.com/lung-cancer/lung-surgery-thoracotomy-for-lung-cancer

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