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Mediastinal Tumor Resection

Definition

The mediastinum is surrounded by the breastbone in front, the spine in back, and the lungs on each side. Mediastinal tumor resection removes tumors in this area of the chest cavity.
Regions of the Lung
BQ00042 97870 1 Regions Lung
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Reasons for Procedure

Cancerous tumors must be removed to prevent local tissue damage and 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, esophagus, or spinal cord.
People who have this surgery often have a better prognosis than those who receive either radiation or chemotherapy .

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
  • 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
  • Lung collapse
  • Drainage, infection, or bleeding
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

What to Expect

Prior to Procedure

Before the surgery, your doctor may do the following:
Leading up to the surgery:
  • Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure, like:
    • Anti-inflammatory drugs
    • Blood thinners
    • Antiplatelets
  • 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.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery.

Description of the Procedure

You will have a breathing tube and be given an IV. The IV will be used to give you medications and fluids during the surgery.
To remove the tumor, the doctor will make one large, central incision in the chest, an incision between the ribs, 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.
Tubes may be inserted into your chest. These tubes will help to drain fluid and air from the chest cavity. The incisions will be closed with staples or stitches.

Immediately After Procedure

The breathing tube will be removed. You will be monitored closely for any complications from the procedure.

How Long Will It Take?

About 1-4 hours depending on the type of surgery

How Much Will It Hurt?

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay

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.

Post-procedure Care

At the Hospital
After your recover from surgery, you may need chemotherapy and/or radiation therapy.
You will be given a clear liquid diet .
You will be instructed to practice deep breathing and coughing to help your lungs recover.
Any chest tubes will be removed before you go home.
When 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.Return to work when you doctor says it is alright.
Preventing Infection
During your stay, the hospital staff will take steps to reduce your chance of infection, such as:
  • Washing their hands
  • Wearing gloves or masks
  • Keeping your incisions covered
There are also steps you can take to reduce your chance of infection, such as:
  • Washing your hands often and reminding your healthcare providers to do the same
  • Reminding your healthcare providers to wear gloves or masks
  • Not allowing others to touch your incision

Call Your Doctor

Call your doctor if any of the following occur:
  • 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 medications you have been given
  • Cough, difficulty breathing, or chest pain
  • Persistent nausea and/or vomiting
  • Loss of appetite
  • Pain and/or swelling in your feet, calves, or legs
  • Any other worrisome symptoms
If you think you have an emergency, call for medical help right away.

RESOURCES

American Cancer Society http://www.cancer.org

National Cancer Institute http://www.cancer.gov

CANADIAN RESOURCES

BC Cancer Agency http://www.bccancer.bc.ca

Canadian Cancer Society http://www.cancer.ca

References

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%5Ftech-3.html. Updated January 26, 2010. Accessed May 23, 2013.

Liu HP, Yim AP, et al. Thorascopic removal of intrathoracic neurogenic tumors: a combined Chinese experience. Annals of Surgery. 2000;232:187-190.

6/3/2011 DynaMed's Systematic Literature Surveillance https://dynamed.ebscohost.com/about/about-us: 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.

Revision Information

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