A thoracotomy is a surgery to open the chest wall. The surgery allows access to the lungs, aorta, heart, diaphragm, and spine. Depending on the disease location, a thoracotomy may be done in the center, or on the right or left side of the chest.
A thoracotomy may be done to:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Factors that may increase the risk of complications include:
Your doctor may perform:
Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Before your procedure, you may need to:
General anesthesia will be given—you will be asleep during the procedure
You will be placed on your side with your arm elevated. An incision will be made between two ribs, from front to back. The chest wall will then be opened. In some cases, the doctor may take a different approach. The doctor can then do whatever procedure needs to be done in the open chest. When the procedure is done, one or more chest tubes will be placed. The tubes will make sure that blood or air does not collect in the chest. The chest wall will be closed. The incision is closed with stitches or staples and bandaged to prevent infection.
Incision and Drainage Tubes
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You will be closely monitored in the intensive care unit.
3-4 hours or longer
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.
For some, a thoracotomy can lead to a chronic pain syndrome. It is usually described as burning pain in the area of surgery. It may be associated with increased sensitivity to touch in this area. It usually lessens over time, but you may need to see a pain specialist if the pain persists.
The usual length of stay is 5-10 days. Your doctor may choose to keep you longer if complications arise.
During your recovery:
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
There are also steps you can take to reduce your chance of infection, such as:
If you smoke, talk to your doctor about how to successfully quit. You may need to avoid places that expose you to smoke, germs, or chemical irritants. Follow instructions on wound care to prevent infection. Your doctor may advise medications to ease discomfort.
It is important for you to monitor your recovery after you leave the hospital. Alert your doctor to any problems right away. If any of the following occur, call your doctor:
If you think you have an emergency, call for medical help right away.
American Thoracic Society
The Society of Thoracic Surgeons
Canadian Society for Vascular Surgery
The Lung Association
Athanassiadi K, Kakaris S, et al. Muscle-sparing versus posterolateral thoracotomy: a prospective study. Eur J Cardiothorac Surg. 2007;31:496-500.
Levy MH, Chwistek M, et al. Management of chronic pain in cancer survivors. Cancer J. 2008;14(6):401-409.
Ohbuchi T, Morikawa T, et al. Lobectomy: video-assisted thoracic surgery versus posterolateral thoracotomy. Jpn J Thorac Cardiovasc Surg. 1998;46(6):519-522.
Video-assisted thoracoscopic surgery (VATS). University of Southern California, Cardiothoracic Surgery website. Available at:
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Accessed May 22, 2013.
Wildgaard K, Ravn J, et al.Chronic post-thoracotomy pain: A critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg. 2009;36(1):170-180.
Last reviewed February 2015 by Michael Woods, MD
Last Updated: 3/18/2013