Mediastinal Tumor Resection
En Español (Spanish Version)This is surgery to remove tumors in the area of the chest cavity that separates the lungs.
Regions of the Lung
Copyright © Nucleus Medical Media, Inc.
Malignant (cancerous) tumors must be removed to prevent the spread of cancer. Without removal or treatment, the cancer could spread to other areas of the body. The cancer could also start to compress organs in the chest, such as the heart, lungs, or esophagus.
Patients who undergo this surgery often have a better prognosis than those who receive either
radiation
or
chemotherapy
.
Complications are rare, but no procedure is completely free of risk. If you are planning to have mediastinal tumor resection, your doctor will review a list of possible complications, which may include:
- Damage to the areas surrounding the tumor, including the heart, lungs, and spinal cord
- Fluid collecting between the lung tissue lining and the wall of the chest cavity
- Drainage, infection, or bleeding
Factors that may increase the risk of complications include:
Before the surgery, your doctor may do the following:
- Physical exam
- Blood tests
- X-ray
—a test that uses radiation to take a picture of structures inside the body
- MRI scan
—a test that uses magnetic waves to make pictures of structures inside the body
- CT scan
—a type of x-ray that uses a computer to make pictures of the inside of the body
- PET scan
—a test that uses radiation to show activity in body tissue
Leading up to the surgery:
-
Talk to your doctor about your medicines. You may be asked to stop taking some medicines up to one week before the procedure, like:
-
Anti-inflammatory drugs (eg,
aspirin
)
-
Blood thinners (eg,
clopidogrel
[Plavix])
-
Anti-platelet drugs (eg,
warfarin
[Coumadin])
- Eat a light meal the night before the surgery. Do not eat or drink anything after midnight.
- Arrange for someone to drive you home from the hospital. Also, arrange for help at home.
General anesthesia
will be used. It will block any pain and keep you asleep through the surgery.
You will have a breathing tube and be given an IV. The IV will be used to give you medicines and fluids during the surgery.
To remove the tumor, the doctor will either make one large, central incision in the chest or several small incisions. If several small incisions are made, a camera will be inserted into one incision. The camera will allow the doctor to view the area via monitor. Through the other incisions, surgical tools will be inserted.
The doctor may insert tubes in your chest. These tubes will help to drain fluid and air from the chest cavity. The incisions will be closed with staples or stitches.
The breathing tube will be removed. You will be monitored closely for any complications from the procedure.
About 1-4 hours (depending on the type of surgery)
The anesthesia will ease discomfort after surgery. It is common for the surgical area to be tender. Your doctor will give you pain medicine.
This surgery is done in a hospital setting. The usual length of stay is four days. Your doctor may choose to keep you longer if complications arise.
After surgery, you may need
chemotherapy
and/or
radiation therapy.
In the hospital, you will be given a
clear liquid diet
. You will be instructed to practice deep breathing and coughing to help your lungs recover.
Once you are home, be sure to follow your doctor's instructions, including:
- Avoid lifting objects heavier than five pounds.
- Do not to drive for 4-6 weeks.
- Increase your activity as you are able. This will help you recover.
Ask your doctor about when it is safe to shower, bathe, or soak in water.
After you leave the hospital, contact your doctor if any of the following occurs:
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or any discharge from the incision site
- Pain that you cannot control with the medicines you have been given
- Cough, difficulty breathing, or chest pain
- Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Loss of appetite
- Pain and/or swelling in your feet, calves, or legs
- Any other worrisome symptoms
In case of an emergency, call for medical help right away.
National Cancer Institute
Flores RM. Surgical management of primary mediastinal germ cell tumors. The Cardiothoracic Surgery Network website. Available at:
http://www.ctsnet.org/sections/clinicalresources/thoracic/expert_tech-3.html
. Updated May 2005. Accessed March 1, 2007.
Khatri VP, Asensio JA.
Operative Surgery Manual
.
Philadelphia, PA: Saunders; 2003.
Liu HP, Yim AP, Wan J, et al. Thorascopic removal of intrathoracic neurogenic tumors: a combined Chinese experience.
Annals of Surgery
.
2000;232:187-190.
Townsend CM, et al.
Sabiston Textbook of Surgery
.
17th ed. Philadelphia, PA: Saunders; 2004.
6/3/2011 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed/
: Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis.
Am J Med.
2011;124(2):144-154.e8.
Last Reviewed December 2011