Mediastinal Tumor Resection Overview

This is surgery to remove tumors in the area of the chest cavity that separates the lungs.

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Prior to Procedure

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

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, such as clopidogrel (Plavix) or 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.

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 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.

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?

The anesthesia will ease discomfort after surgery. It is common for the surgical area to be tender. Your doctor will give you pain medicine.

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

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.

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/default.htm/

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_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.