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What is a thoracotomy?

A thoracotomy is a surgical procedure performed by an incision on the chest to examine a lung sample tissue, which helps diagnose and treat lung and cardiac ailments such as coronary artery disease, congenital lung defects and pericardial disease.

A thoracotomy may also be performed to inflate a collapsed lung, treat lung cancer, or remove an abnormality that a child may have been born with.


How are congenital lung formations diagnosed?

These usually form while a baby’s lungs develop in the womb. These formations include cysts (abnormal sacs in the body containing fluid), solid growths, or a mixture of the two.

Doctors can detect these formations during pregnancy via ultrasound or fetal (Magnetic Resonance Imaging (MRI).

After birth, the most effective way to diagnose lung formations is by performing a CT scan or a chest X-ray. In addition, the doctor may insert a small camera to view the lungs and airways (bronchoscopy) or get an ultrasound image of the baby’s heart (echocardiogram).


Types of Congenital Lung Formations

  • Congenital Cystic Adenomatoid Malformations (CCAMs): These form when a portion of a baby’s lung tissue grows excessively. This growth may result in cysts ranging in size.
  • Pulmonary Sequestrations (PSs): This refers to solid masses of lung tissue, usually detached from the rest of the lung. They are not connected to the normal airways or blood supply.

When is surgery needed?

The severity of symptoms that come with congenital lung formations will influence the decision to have surgery. Before the decision is made, a discussion is held between a child’s parents and their doctor.

The symptoms that may affect a child’s health include:

  • Difficulty with breathing
  • Wheezing
  • Recurring chest infections such as pneumonia
  • Shortness of breath
  • Poor feeding and weight gain
  • Painful breathing

What can I expect from surgery?

Your child will need to recover from the incision where the lung formation was located. After surgery, they will either be in the recovery room or Neonatal Intensive Care Unit (NICU). The duration of their stay depends on how severe the lung formations were before the surgery, your child’s recovery rate and how quickly they can go back to regular feeding.

Your child’s discharge depends on how things play out after surgery. For the hospital to discharge your child, they must meet the following:

  • Take pain medication orally
  • Be free of infections
  • Have an average body temperature
  • Be fed regularly without difficulty

In cases where your child is discharged after one week, the surgeon will typically schedule a follow-up visit two to three weeks after surgery to ensure that the incision is healing correctly.

If your child is admitted for more than a week, the surgeon will closely monitor them while they are still in the hospital.


How to care for my child at home?

Following the guidelines your healthcare practitioner will give as they discharge you from the hospital is essential. Below are a few things to consider:

  • Observe the prescription that they will provide. Typically, they will prescribe pain medication and an anti-inflammatory. The recovery usually runs smoothly, and the discomfort and soreness can be controlled by over-the-counter medication.
  • Your child will recover physically and be able to resume their regular activities, such as getting out of bed and walking, in no time.
  • When bathing, your child should avoid running water for five days after surgery. Instead, they can take sponge baths.
  • Your child’s diet should return to normal once they get home.