Complete thoracoscopic diaphragm plication using carbon dioxide insufflation: report of a case

Homma, Takashi; Yamamoto, Yutaka; Doki, Yoshinori; Senda, Kazutaka; Touge, Masayoshi; Ojima, Toshihiro; Shimada, Yasuhiro; Yoshimura, Naoki

doi:10.1007/s00595-014-1008-z

Cited by 6 publications

(4 citation statements)

References 7 publications

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“…Using CO 2 insufflation for thoracoscopic plication was effective, and VATS with CO 2 insufflation is becoming common. CO 2 gas insufflation provided excellent working space and made the stitching easy until the diaphragm was nearly flat [12]. The simplicity of this operation may be safe and is associated with a low risk of morbidity for patients.…”

Section: Discussionmentioning

confidence: 99%

A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report

et al. 2019

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Background Pulmonary carcinoma patients with low pulmonary function cannot be treated surgically because of the high risk of complications. Diaphragmatic eventration is a disease characterized by diaphragmatic paralysis and dyspnea. Here, we report a surgical case of multiple pulmonary carcinomas with contralateral diaphragmatic eventration. Case presentation The patient was a 75-year-old woman with multiple metachronous right lung carcinomas complicated by left diaphragmatic eventration. When she was 70 years old, a right upper lobectomy and right S 6 b wedge resection were performed for double lung carcinomas. Five years later, two new lung tumors in her right lower lobe and left diaphragmatic eventration were identified, but resection was thought to be impossible because of her low pulmonary function. We performed video-assisted thoracoscopic surgery (VATS) plication with carbon dioxide (CO 2 ) insufflation for the left diaphragmatic eventration, and her pulmonary function improved. Subsequently, we performed a right S 6 wedge resection and right S 9 segmentectomy for the double lung tumors with no complications. The tumors were diagnosed as double primary carcinomas. Conclusions Our case presented with low pulmonary function and right multiple lung carcinomas with left diaphragmatic eventration. VATS plication for the left diaphragmatic eventration achieved improvement in her pulmonary function, and right pulmonary resection for the lung carcinomas was performed. VATS plication can expand the choice of treatments in such cases.

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Section: Discussionmentioning

confidence: 99%

A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report

et al. 2019

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“…We diagnosed the condition as idiopathic because there was no history of trauma or neoplastic lesions in the cervicothoracic region. Diaphragmatic plication is sometimes performed for diaphragmatic eventration if there are respiratory symptoms or dysfunction . Gastric volvulus, reflux esophagitis, ileus, and sigmoid volvulus are also known to concomitantly occur with diaphragmatic eventration .…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic distal gastrectomy in a patient with gastric cancer complicated by eventration of the diaphragm: A case report

Fujii

Haruta

Ohkura

et al. 2018

Asian J Endoscop Surgery

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Diaphragmatic eventration refers to an abnormal elevation of the diaphragm. Here, we report the case of a patient with gastric cancer who underwent successful laparoscopic distal gastrectomy despite the presence of diaphragmatic eventration. The patient was a 72-year-old man diagnosed with early gastric cancer in the antrum, as detected by upper gastrointestinal endoscopy. Preoperative imaging revealed an elevation of the left side of the diaphragm, which was diagnosed as diaphragmatic eventration. Laparoscopic surgery is beneficial for obtaining an optimal field of view. However, there are critical points that must be considered when laparoscopic distal gastrectomy is performed in patients with gastric cancer complicated by diaphragmatic eventration. There were difficulties that affected manipulation because the elevated diaphragm drew the intraperitoneal organs into the thoracic cavity, causing displacement of the normal anatomical position. We found it beneficial to secure the lesser curvature of the stomach given the possible effects of gastric deformation. Figure 4 A postoperative upper gastrointestinal series showed that gastrojejunal anastomosis flow was smooth.

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“…Risks include hypercapnia, hemodynamic instability, and acidosis [6], but insufflation pressure <10 mm Hg can prevent such risks. An improved surgical field exposure allowed for shorter operative times in this study.…”

Section: Discussionmentioning

confidence: 99%

Surgical Outcomes of Pneumatic Compression Using Carbon Dioxide Gas in Thoracoscopic Diaphragmatic Plication

Ahn

Kim

Hoseok

et al. 2016

Korean J Thorac Cardiovasc Surg

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BackgroundSurgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide (CO2) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy.MethodsEleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using CO2 gas and group without using CO2 gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence.ResultsThe improvement of forced expiratory volume at 1 second in the group using CO2 gas and the group not using CO2 gas was 22.46±11.27 and 21.08±5.39 (p=0.84). The improvement of forced vital capacity 3 months after surgery was 16.74±10.18 (with CO2) and 15.6±0.89 (without CO2) (p=0.03). During follow-up (17±17 months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred.ConclusionThoracoscopic plication under single lung ventilation using CO2 insufflation could be an effective, safe option to flatten the diaphragm.

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Complete thoracoscopic diaphragm plication using carbon dioxide insufflation: report of a case

Cited by 6 publications

References 7 publications

A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report

A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report

Laparoscopic distal gastrectomy in a patient with gastric cancer complicated by eventration of the diaphragm: A case report

Surgical Outcomes of Pneumatic Compression Using Carbon Dioxide Gas in Thoracoscopic Diaphragmatic Plication

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