Difficulties in tracheal extubation due to phrenic nerve injury during massive mediastinal tumor resection

Wang, Kui-Rong; Liu, Fan-Fan; Zhou, Yanfeng

doi:10.1097/md.0000000000016252

Cited by 5 publications

(4 citation statements)

References 16 publications

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“…However, phrenic nerve palsy may also occur in cases in which the lesion does not invade but is only adjacent to the phrenic nerve. [21] This might be due to stretching, crushing or demyelination of the nerve during surgery, just like the case 3 in the present report. [22] Therefore, preoperative assessment of the risk of phrenic nerve injury is a key imperative.…”

Section: Discussionsupporting

confidence: 62%

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study

Fang,

Wu,

Zhang

et al. 2023

Medicine

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Rationale: Cases of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor have rarely been studied in detail. Diaphragmatic dysfunction in such cases can lead to potentially fatal respiratory and circulatory disturbances. Therefore, timely diagnosis and intervention are important. Conservative rehabilitation therapy is the first choice for respiratory dysfunction due to diaphragmatic dysfunction. Patient concerns, Diagnoses and Interventions: We present 3 patients with respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. The diagnostic methods and therapeutic procedures for diaphragmatic dysfunction for each patient are described in detail. This study highlights the role of ventilator support combined with physical therapy in the treatment of respiratory dysfunction in such cases. The diagnosis of diaphragmatic dysfunction as well as the risk assessment of phrenic nerve involvement are also discussed. The modalities of ventilator support, including modes and parameters, are listed. Outcomes and Lessons: This study provides experiences of diagnosis and treatment of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. Timely diagnosis of diaphragmatic dysfunction primarily relies on clinical manifestations and radiography. Conservative rehabilitation therapy can improve or restore diaphragmatic function in majority of patients, and avert or delay the need for surgical intervention. Preoperative assessment of the risk of phrenic nerve involvement is important in such cases.

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Section: Discussionsupporting

confidence: 62%

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study

Fang,

Wu,

Zhang

et al. 2023

Medicine

View full text Add to dashboard Cite

show abstract

“…To achieve R0 resection and better prognosis, the involved phrenic nerve had to be sacri ced. However, phrenic nerve palsy may also occur in cases in which the lesion does not invade but is only adjacent to the phrenic nerve (21). This might be due to stretching, crushing or demyelination of the nerve during surgery, just like the case 3 in the present report (22).…”

Section: Discussionmentioning

confidence: 49%

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor

Zhang

et al. 2023

Preprint

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Background: Cases of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor have rarely been studied in detail. Diaphragmatic dysfunction in such cases can lead to potentially fatal respiratory and circulatory disturbances. Therefore, timely diagnosis and intervention are important. Conservative rehabilitation therapy is the first choice for respiratory dysfunction due to diaphragmatic dysfunction. Case presentation: We present three patients with respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. The diagnostic methods and therapeutic procedures for diaphragmatic dysfunction for each patient are described in detail. This study highlights the role of ventilator support combined with physical therapy in the treatment of respiratory dysfunction in such cases. The diagnosis of diaphragmatic dysfunction as well as the risk assessment of phrenic nerve involvement are also discussed. The modalities of ventilator support, including modes and parameters, are listed. Conclusions: This study provides experiences of diagnosis and treatment of respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor. Timely diagnosis of diaphragmatic dysfunction primarily relies on clinical manifestations and radiography. Conservative rehabilitation therapy can improve or restore diaphragmatic function in majority of patients, and avert or delay the need for surgical intervention. Preoperative assessment of the risk of phrenic nerve involvement is important in such cases.

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“…In addition, the occurrence of complications is often the main cause of surgical failure. Postoperative complications of complicated thoracic tumor surgery mainly include recurrent pulmonary edema, pulmonary infection, arrhythmia, respiratory failure, pleural effusion, and wound bleeding (22,23). The incidence of total complications was no significant difference between the research group and the control group.…”

Section: Discussionmentioning

confidence: 86%

Application of 3D modeling and printing technology in accurate resection of complicated thoracic tumors

Tan¹,

Yao²,

Hua

et al. 2020

Ann Transl Med

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Background: To explore the application value of three-dimensional (3D) reconstruction and 3D printing in preoperative evaluation of precise resection of complicated thoracic tumors. Methods: A retrospective analysis of 34 patients with complicated thoracic tumors who were treated by radical surgery from March 2016 to June 2019 was made. According to whether 3D reconstruction and 3D printing was used, the patients were divided into research group and control group. In the control group, preoperative evaluation was performed according to CT image data, and the operation plan was drawn up; in the research group, preoperative simulation and preoperative operation plan design were carried out according to 3D reconstruction and 3D printing technology. The operation time, change of operation approach, intraoperative blood loss, hospitalization time and postoperative complications were compared between the two groups. We also retrospectively reviewed additional 12 cases of unresectable complicated thoracic tumors. The above 34 patients who were treated by radical surgery were set as the resectable group. Three-dimensional reconstruction was performed for all cases. The tumor size, location, smoothness of tumor-vascular contact surface, close contact with adjacent organs were compared between these two groups.Results: The 3D reconstruction and 3D printing model were successfully established. The indexes of operation time, change of incision approach and blood loss in the research group were lower than those in the control group (P<0.05). All the patients were followed up for 6 months, and there was no death, no tumor recurrence and metastasis in the two groups. In the unresectable group, the score of position and smoothness of tumor-vascular contact surface were significantly higher than that in the resectable group.Conclusions: 3D reconstruction and 3D printing can effectively help surgeons carry out accurate surgical treatment, reduce the operation time and bleeding, reduce the risk of surgery, and facilitate the postoperative rehabilitation of patients, which has the value of promotion and application.

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Difficulties in tracheal extubation due to phrenic nerve injury during massive mediastinal tumor resection

Cited by 5 publications

References 16 publications

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor: A case series study

Conservative rehabilitation therapy for respiratory dysfunction due to phrenic nerve sacrifice during resection of massive mediastinal tumor

Application of 3D modeling and printing technology in accurate resection of complicated thoracic tumors

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