Thoracic Surgery

Memorial Health University Physicians -- CVT Surgery performs the following thoracic surgeries:

Thoracic aortic aneurysms and dissections
Thoracic operations (chest surgery)

• Partial and total lung resection for lung cancer and infectious diseases
• Chest wall surgery
• Video assisted thoroscopic surgery (VATS)
• Mediastinal surgery (Mediastinoscopy and Mediastinotomy)
• Thoracic endoscopic procedures
• Esophageal surgery for cancer - hiatal hernia and other esophageal diseases

Implantation of Vagus Nerve Stimulator for epilepsy
Spinal exposure for orthopedic & neurologic procedures

• Transthoracic
• Transabdominal
• Retroperitoneal

Initial Consult
Our specialists will review your medical records from the referring physician and conduct their own examination. We will then discuss your upcoming surgical procedure, when you will need to have it, your expected length of stay in the hospital, as well as the risks, benefits, and options for surgery.

Preparation at Home
You may be asked to discontinue use of certain medications before your admission to the hospital. Check with your doctor if you are currently using any of the following:

• Aspirin or any medications containing aspirin
• Anticoagulants (blood thinners)
• Any other prescription medications
• Cigarettes (the earlier you quit smoking before your operation, the more responsive your heart and lungs will be after surgery)

It is also important to let us know if you have any sores, cuts, colds, or urine or bladder infections at the time of the operation.

The Night Before Surgery
You should eat a normal meal for dinner the night before your surgery, but do not eat or drink anything (including water) after midnight. You might be asked to shower with a special antibacterial soap before going to bed the night before your operation. This will reduce the risk of infection.

The Surgery
On the morning of your surgery, a surgical technician will prepare you for surgery. Preparation involves shaving the area of skin where the incision is going to be made and washing the area with antibacterial soap. During the surgery you may have chest tubes, intravenous catheters (IVs), urinary catheters, and breathing tubes inserted. Your heart will be monitored for rhythm, blood pressure, and oxygen levels. You will be given medication and fluids through the IVs while the surgeon performs the operation.

After Surgery
An epidural is available for pain if you need it. The chest tubes and IVs should be removed within three to four days. The breathing tube will be removed once you no longer need it. A therapist will assist you on breathing exercises to reduce your chances of post-operative infections. Your diet will be minimal after the operation and gradually increased. Your appetite and energy level will also increase in the days to follow.

You will probably need to spend at least one day in the Cardiovascular Intensive Care Unit (CVICU). You will be on a liquid diet at first and then slowly progressed back to a normal diet. You will then start a walking program, which will help improve your lung function, muscle strength, appetite, nervous system, and blood circulation. A therapist or nurse will initially assist you to ensure your safety and to evaluate your progress. The length of stay varies depending on the patient and what type of surgery was performed. The average length of stay is usually four to six days.

Don't Worry If…

• You get fatigued during the days immediately following surgery. Being active will help you recover more quickly.
• You are constipated for a few days following surgery. This is a common result of anesthesia - walking will help with this problem.
• You run a mild fever. Walking should help alleviate this problem.
• You experience mood swings or sadness following surgery. If they are prolonged, however, you should consult with your doctor.

General Instructions Upon Discharge
You will be instructed on activities you should and should not do after surgery, but here is a list to assist you.

• You should avoid tub baths for four to six weeks or until your incisions are healed. A shower would be better. Do not use creams or lotions on your incisions until they have healed.
• You should avoid driving a car for four weeks as your reaction time will be delayed due to weakness, fatigue, or the medications.
• Your activities should be spaced throughout the day. You should also pace yourself during these activities - gradually get back into your original routine.
• You can climb stairs, but do not pull yourself up using the handrails.
• You should take your temperature every morning for about a week and notify the physician if it stays above 100 degrees for more than a day.
• If you have a sudden weight gain, notify the physician.

Lung surgery impacts not only the patient, but significant others as well. It is helpful to have your family's support during this time. Everyone involved needs to understand that changes are taking place - whether it is smoking cessation, diet, exercise, or emotional swings. A patient who has undergone lung surgery has a different outlook on life. Support from loved ones is key to recovery and ultimately a healthier life.