Mediastinal Tumor Resection
DefinitionThe 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|
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Reasons for ProcedureCancerous 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 therapy or chemotherapy.
Possible ComplicationsProblems 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
What to Expect
Prior to ProcedureBefore the surgery, your doctor may do the following:
- Physical exam
- Blood tests
- Take images of structures inside your body using x-ray , MRI scan , CT scan , or PET scan
- Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
- 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.
- Arrange for help at home.
AnesthesiaGeneral anesthesia—you will be asleep during the procedure
Description of the ProcedureYou 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 ProcedureThe 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 StayThis surgery is done in a hospital setting. The usual length of stay is 4 days. Your doctor may choose to keep you longer if complications arise.
Post-procedure CareAt the HospitalAfter 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:
- Avoid lifting objects heavier than 5 pounds.
- Do not to drive for 4-6 weeks.
- Increase your activity as you are able. This will help you recover.
- Follow instructions about wound care to avoid infection.
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
- 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 DoctorIt 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:
- 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've 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
- New or worsening symptoms
American Cancer Society
National Cancer Institute
BC Cancer Agency
Canadian Cancer Society
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. Ann Surg. 2000;232(2):187-190.
6/3/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Mills E, Eyawo O, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.
- Reviewer: Michael Woods, MD
- Review Date: 01/2015
- Update Date: 01/23/2014