What do the tests before surgery mean?
A number of tests are performed before surgery and some tests may need to be repeated. Tests may be done for different reasons, such as to find the diagnosis or to find out how advanced a cancer is. Before surgery we do tests to check your fitness and for unexpected problems. Some tests help us plan how to do the operation. Some results will be available immediately but most tests will take several days for the results.
After a test you should have a follow up appointment booked or we may phone to speed things up. If you are not sure what will happen next, or if you have extra questions please ask your doctor or nurse.
You will have a blood test the first day after your operation and again if we need to monitor one of the tests.
- Endobronchial ultrasound
An endobronchial ultrasound (EBUS) is like a bronchoscopy and done using local anaesthetic and sedation. The flexible camera has an ultrasound probe attached which allows the doctor to see any enlarged glands (lymph nodes) through the wall of the wind pipe. Samples of the glands can then be taken. Samples are then looked at under a microscope to try and find the diagnosis.
- CT guided biopsy
A CT scan may show a shadow that is easy to get to using a needle to get a sample (biopsy). A radiology doctor will use the CT scan to decide the best place to take a sample from using the CT scanner. The doctor does an injection to numb part of the chest (local anaesthetic) then takes the sample with a needle. The sample is looked at under the microscope to find the diagnosis. Most people do not have a problem having the biopsy, other people have discomfort. If you are in pain or want to stop please tell the doctor and they can help you.
Surgery may be recommended both to get a biopsy and help treat symptoms.
The following are operations that may be done to get a diagnosis:
- Biopsy by a cut on the neck (cervical mediastinoscopy)
- Biopsy by a cut on the front of the chest (anterior mediastinotomy)
- Pleural biopsy
- Lung biopsy
- Frozen section
Lung tissue and lymph glands which are removed are sent to the laboratory to be looked at under the microscope, this is called histology. It is a delicate process and takes about 2 weeks to get results. Histology can help us diagnose lung disease and also assess the stage of lung cancer. Histology results will be discussed with you in clinic.