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

Abstract

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.

Long-term efficacy of diaphragm plication on the pulmonary function of adult patients with diaphragm paralysis: a retrospective cohort study

“…The surgical treatment of diaphragm paralysis was first described in 1985 (7,8). Diaphragm plication is recommended as an effective and safe procedure for patients with symptomatic, acquired diaphragm paralysis (9). There is still controversy about the long-term outcome of surgical treatment of acquired diaphragm paralysis, Improvements in dyspnea scores and ventilation perfusions have been reported in a majority of patients and even an impressive improvement in exercise capacity has been observed (10).…”