Comparison of Mid-Term Clinical Outcomes of Different Surgical Approaches in Symptomatic Diaphragmatic Eventration

Evman, Serdar; Tezel, Çağatay; Vayvada, Mustafa; Kanbur, Serda; Ürek, Şenol; Baysungur, Volkan; Yalçınkaya, İrfan

doi:10.5761/atcs.oa.16-00018

Cited by 11 publications

(6 citation statements)

References 16 publications

(39 reference statements)

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“…Our patient was treated chronically for bronchial asthma, with episodes of seizures and recurrent bronchial infections. Digestive symptoms, such as nausea, vomiting, flatulence, abdominal pain, epigastralgia, constipation, anorexia, difficulty in gaining weight, and varying degrees of gastroesophageal reflux, may coexist [21]. Pulmonary function tests (PFTs) are important for a dyspneic patient with an elevated hemidiaphragm for highlighting the forced vital capacity and forced expiratory volume in 1 second, showing a restrictive pattern.…”

Section: Discussionmentioning

confidence: 99%

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Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature

Carrasco¹,

Castro²

2018

Case Reports in Surgery

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We aimed to review the publications on the diagnosis of diaphragmatic eventration and report on the clinical presentation and surgical treatment of a female patient aged 17 years. The present case, though quite infrequent, shows the presence of an ectopic thoracic kidney on the right side. The clinical features included dry cough, chest pain, respiratory distress, and bronchial spasms for 4 years; additionally, the patient had episodes of bronchial asthma since her childhood. The right hemithorax presented invasion of the thin loops, right colon, and kidney. The treatment approach was laparoscopic followed by thoracotomy using a dual mesh. The intrathoracic kidney remained in place. The outcome was satisfactory. Diaphragmatic eventration associated with thoracic renal ectopia is a very rare entity, considering the age, sex, and right location of the condition. It represents a clinical and diagnostic challenge; clinicians, radiologists, and surgeons must be alert with a high degree of suspicion in order to correlate symptoms and imaging findings and understand the etiopathogenesis. In addition, they should plan an adequate and individualized surgical repair making use, as far as possible, of the minimally invasive procedures that are currently used.

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Section: Discussionmentioning

confidence: 99%

“…Evman et al [21] reported 42 patients with accordion plication, consisting of several rows of nonabsorbable suture, which are then adjusted to cause “wrinkling” of the diaphragm. The author compared this procedure with the “Mayo technique” that forces the diaphragm to impinge and imbricate the two sheets (“double breasted”).…”

Section: Discussionmentioning

confidence: 99%

Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature

Carrasco¹,

Castro²

2018

Case Reports in Surgery

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“…Они достаточно просты, малотравматичны и дают удовлетворительные непосредственные результаты [11]. Предложены различные технические приемы реконструкции диафрагмы: резекция истонченного участка диафрагмы, гофрирование без рассечения диафрагмы, использование матрацных или непрерывных швов, механического шва с помощью эндостеплера [17,20,28,30,35,45,47].…”

Section: Discussionunclassified

Diaphragm relaxation surgery

Паршин

Khetagurov

2018

Khir. Z. im. N.I. Pirogova

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Postoperative morbidity and mortality was 20% (n=6) and 4% (n=1) respectively. Long-term results were followed-up within terms from 8 months to 12 years. Recurrent relaxation was absent. Most of patients had improved dyspnea, increased vital capacity and FEV1 in long-term period. Certain and general values of SF-36 life quality questionnaire were high in long-term postoperative period and similar to those in general population.

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“…We also achieved a postoperative increase in pulmonary function in our patients, and this improvement, as is well known, ensures symptomatic relief and reflects directly on the patients' clinic [13]. Therefore, we recommend our modification of diaphragm plication to make this procedure safer, easier, more A B Figure 3.…”

Section: Discussionmentioning

confidence: 99%

Minimally invasive thoracoscopic surgery with laparoscopic assistance approaches in diaphragmatic eventration management

Panko¹,

Karpitski²,

Zhurbenko³

et al. 2017

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Introduction: Thoracoscopic plication is an effective treatment for diaphragmatic eventration, but the procedure has some disadvantages such as inadvertent abdominal organ injuries or superficial sutures that are not strong enough. Aim of the research: In this study, we devised and tested the method of diaphragm plication through simultaneous laparoscopic-and thoracoscopic-assisted left mini-thoracotomy. Material and methods: During the period between October 2012 and March 2014 there were four patients operated on for left-sided diaphragmatic paralysis. The average age was 52.3 ±17.8 years. The preoperative examination included a routine laboratory study, spirometry, plain chest radiograph, and computed tomographic scan of the chest. The initial part of the surgery was a two-port laparoscopy to remove the adhesions between the abdominal viscera and the abdominal segment of the diaphragm using bipolar electrocautery. After that, video-assisted thoracoscopic surgery plication of the diaphragm was performed via anterior mini thoracotomy. Results: The mean operation time was 58 ±11 min, and the mean hospital stay was 9.0 ±2.1 days. All of the patients demonstrated good postoperative recovery. The descending distance of the diaphragm after the surgery ranged from two to four intercostal spaces, which was confirmed with plain chest X-ray. The follow-up ranged from 20 to 38 months and showed no recurrence of diaphragm elevation symptoms. Conclusions: Simultaneous thoraco-and laparoscopic assisted mini-thoracotomy surgery for diaphragm plication is a safe procedure with strong positive clinical effect, and it can serve as an alternative to conventional thoracoscopic approaches especially in patients with high risk of inadvertent abdominal organ injuries.

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Comparison of Mid-Term Clinical Outcomes of Different Surgical Approaches in Symptomatic Diaphragmatic Eventration

Cited by 11 publications

References 16 publications

Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature

Right Diaphragmatic Eventration with an Intrathoracic Kidney: Case Report and Review of the Literature

Diaphragm relaxation surgery

Minimally invasive thoracoscopic surgery with laparoscopic assistance approaches in diaphragmatic eventration management

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