Resection of mediastinal tumor is the name for the procedure that involves the removal of tumors in the area of the chest cavity that separates the lungs.
Reasons to perform the procedure
Malignant (cancerous) tumors should be removed to prevent the cancer from spreading. Without removal or treatment, the cancer may spread to the heart or begin to compress the spine.
Risk factors of complications during the procedure
- Abnormal heart function
- Compression of the column by the tumor
What to expect
Before the procedure
Generally, a series of tests is required before the day of surgery and may include a physical examination, blood tests, and laboratory work.
You will meet with the anesthesiologist and the surgeon to discuss the procedure. The surgeon may make marks on your body to show where the incisions will be made.
You will receive an intravenous line that delivers blood or fluids during surgery. A catheter will be inserted.
In preparation for the procedure:
Do not take aspirin or other anti-inflammatories for a week before surgery, unless the doctor tells you otherwise. You may also have to stop taking anticoagulants. For example, clopidogrel (Plavix), warfarin (Coumadin) or ticlopidine (Ticlid). Check with the doctor.
General anesthesia is used for this surgery, so you will be asleep during the preparation and surgery. A breathing tube will be placed and an epidural injection will be given to help control the pain and allow you to sleep.
Once the patient is anesthetized, mediastinal tumor resection can be done through a large incision or several small incisions. Traditional mediastinal tumor resection uses a large central incision in the chest, while video-assisted mediastinal tumor resection uses several small incisions, a video camera inserted into an incision, and miniature surgical instruments inserted through the other incisions
Probes can be inserted into the chest to help facilitate drainage of fluid and air from the chest cavity.
After the procedure
The breathing tube is removed, but the epidural injection remains in place to control pain while awake from surgery. A clear liquid diet is administered after surgery.
How long will it last?
Approximately between 1-4 hours, depending on the type of surgery
Will it hurt?
General anesthesia prevents pain during surgery, and an epidural injection relieves discomfort immediately after surgery. Sensitization is common on the site after discharge, but this can be controlled with analgesic medications.
Complications depend on the type of surgery performed to remove the tumor. In a minimally invasive technique, the risk factors include:
- Damage to areas around the tumor, including the heart, pericardium, and spine
- Fluid that accumulates in the middle of the lining of the lung tissue and the wall of the chest cavity
- Drainage, infection, or bleeding after surgery
The average hospital stay is approximately four days, but varies based on the type of surgery performed.
Once you are discharged from the hospital, you should avoid lifting any object heavier than five pounds. You will also be asked not to drive for four to six weeks, but you will be encouraged to walk at least twice a day. Usually, fatigue does not last more than three or four weeks.
No rehabilitation therapy is required after this surgery.
The treatment usually continues after the operation and includes chemotherapy or radiotherapy.
Patients who undergo surgery to remove the mediastinal tumor have a better prognosis than those who receive either radiation or chemotherapy.
Call your doctor if the following occurs
- The incision site turns red or begins to secrete green pus or green / yellow fluid
- The pain becomes severe and does not respond to medications or the type of pain changes significantly
- Pain occurs on the left side of the chest.
- Highest temperature of 101º F
- Shortness of breath
- Extreme fatigue or lack of energy
- Loss of appetite
- Accelerated heartbeat or heart palpitations