Efficacy of intra-operative unilateral diaphragm plication for patients undergoing unilateral phrenicotomy during extended surgery

Tokunaga, Tohru; Sawabata, Noriyoshi; Kadota, Yoshihisa; Utsumi, Tomoki; Minami, Masato; Inoue, Masayoshi; Ohta, Mitsunori; Okumura, Meinoshin

doi:10.1016/j.ejcts.2010.03.012

Cited by 16 publications

(11 citation statements)

References 17 publications

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“…Аналогичные результаты отмечены J. Mouroux [48], который избирал выжидательную тактику в течение 18-24 мес, указывая на возможность спонтанного восстановления. В литературе можно встретить единичные наблюдения профилактических френопликаций, выполненных во время операций, требую-щих резекции диафрагмального нерва [10,40,62]. По данным T. Tokunaga и соавт.…”

Section: Discussionunclassified

“…По данным T. Tokunaga и соавт. [62], использовавших френопликацию у 13 пациентов в ходе расширенных онкологических операций, эта мера позволяет эффективно предотвращать респираторные нарушения в послеоперационном периоде. Мы считаем, что оперативное лечение показано при резком истончении диафрагмы, выявляемое при МСКТ, что может свидетельствовать о серьезных дегенеративных изменениях и невозможности ее восстановления.…”

Section: Discussionunclassified

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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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Section: Discussionunclassified

Diaphragm relaxation surgery

Паршин

Khetagurov

2018

Khir. Z. im. N.I. Pirogova

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“…In our study, morbidity rate was 27.5% and no mortality in Group 2. Tokunaga et al [17] performed intraoperative unilateral diaphragm plication in 13 patients (6 with lung cancer, 6 with mediastinal tumor, and 1 with mesothelioma) undergoing phrenicotomy to prevent postoperative complications. A year after the operation, 10 (77%) patients had no postoperative complications, 3 (23%) had pulmonary complications, and 2 (15%) required prolonged mechanical ventilation.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic Plication: Retrospective Study with 54 Patients

Çelık¹,

Tanju²,

Döngel³

et al. 2013

OJTS

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Objective: This study seeks to evaluate the results of surgery performed according to the etiological causes of diaphragmatic eventration or paralysis. Method: Files of 54 patients (35 males, 19 females; mean age: 39.1 ± 3.01 years) who had undergone diaphragm plication between January 2005 and June 2011 in two clinics located in Istanbul were studied in terms of pulmonary spirometry, applied surgical procedure, duration of hospitalization, morbidity, and mortality. Results: In diaphragm plications, observed etiologies were isolated diaphragmatic eventration without phrenic nerve injury (Group 1) in 20 (37%) patients due to blunt thoracic trauma; Group 2 (thymoma in 19 (35.2%) patients; lung cancer in 7 (12.9%) patients; mediastinal tumor in 3 (5.6%) patients) and congenital heart surgery (Group 3) in 5 (9.3%) patients. The mean time to plication was 7.4 months in Group 1. The mean duration of hospitalization was 4 days in Group 1, 6.2 days in Group 2, 11.8 days in Group 3. Mean forced vital capacity, forced expiratory volume at 1 second improved by 17%, 20.3%, respectively (p < 0.005) in Group 1. In Group 1, mean dyspnea-related hospital admission before plication was 2.4 times. At the end of 6 months after plication mean dyspnea-related hospital admission was 0 time. All of them returned to daily activities or their job within 6 months in Group 1. Postoperative mortality was observed in 2 (3.7%) patients in Group 3 while the overall complication rates were 24%. The morbidity rates were 8%, 27.5%, 60%, respectively; and the mortality rates were 0%, 0%, 40%, respectively. Conclusion: As a result, it could be suggested that early and timely performed plications for diaphragmatic eventration improves functional status and assesses a shorter lenght of stay. On the other hand,simultaneously performed plications in intraoperative phrenic nerve resections can be performed with acceptable morbidity and no mortality. In diaphragmatic paralysis due to congenital heart surgery, morbidity and mortality rate is still high.

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“…Diaphragmatic plication has been performed for the surgical treatment of diaphragmatic paralysis and eventration. Tokunaga et al demonstrated the efficacy of intraoperative diaphragmatic plication by comparing postoperative vital capacity (VC) and forced expiratory volume in 1 s (FEV1) with predicted postoperative VC (ppo VC) and predicted postoperative FEV1 (ppo FEV1) for patients undergoing unilateral phrenectomy during extended surgery [ 2 ]. However, thoracoscopic one-stage pulmonary lobectomy, partial resection of the phrenic nerve, and diaphragmatic plication have seldom been performed for lung cancer invading the phrenic nerve because of technical limitations.…”

Section: Introductionmentioning

confidence: 99%

Thoracoscopic one-stage lobectomy and diaphragmatic plication for T3 lung cancer

Takahashi

Miyajima

Mishina

et al. 2018

J Cardiothorac Surg

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BackgroundCombined resection of a phrenic nerve is occasionally required in T3 primary lung carcinomas invading the phrenic nerve to completely remove a malignant tumour, resulting in diaphragmatic paralysis. We describe the first case of thoracoscopic lobectomy and diaphragmatic plication as a one-stage surgery for lung cancer invading the phrenic nerve.Case presentationA 56-year-old woman with a T3N0M0 primary adenosquamous carcinoma in the left upper lobe presented with suspicious invasion to the anterior mediastinal fat tissue and left phrenic nerve and underwent left upper lobectomy, node dissection, and partial resection of the anterior mediastinal fat tissue with the left phrenic nerve. Furthermore, thoracoscopic diaphragmatic plication was performed as a concomitant procedure. The patient’s postoperative course was favourable, without any complications, and respiratory function was preserved for 1 year postoperatively.ConclusionsThoracoscopic one-stage lobectomy and diaphragmatic plication for T3 lung cancer invading the phrenic nerve is effective for preservation of postoperative pulmonary function.

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Efficacy of intra-operative unilateral diaphragm plication for patients undergoing unilateral phrenicotomy during extended surgery

Abstract: Unilateral diaphragm plication in a patient undergoing a unilateral phrenicotomy during an extended thoracic operation is effective to prevent postoperative pulmonary complications and to preserve postoperative lung function.

Cited by 16 publications

References 17 publications

Diaphragm relaxation surgery

Diaphragm relaxation surgery

Diaphragmatic Plication: Retrospective Study with 54 Patients

Thoracoscopic one-stage lobectomy and diaphragmatic plication for T3 lung cancer

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