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

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• 作者：Toshiteru Tokunaga ; Noriyoshi Sawabata ; Yoshihisa Kadota ; Tomoki Utsumi ; Masato Minami ; Masayoshi Inoue ; Mitsunori Ohta ; Meinoshin Okumura
• 关键词：Phrenicotomy ; Diaphragm plication ; Pulmonary complication ; Operation
• 刊名：European Journal of Cardio-Thoracic Surgery
• 出版年：2010
• 出版时间：November 2010
• 年：2010
• 卷：38
• 期：5
• 页码：600-603
• 全文大小：121 K

文摘

Objective: Diaphragm plication is used to improve lung function and respiratory insufficiency in patients suffering from diaphragm paralysis. We assessed the efficacy of intra-operative unilateral diaphragm plication for prevention of postoperative pulmonary complications in patients, who underwent a phrenicotomy due to extended surgical intervention. Methods: Intra-operative unilateral diaphragm plication was performed in 13 patients, who underwent a unilateral phrenicotomy during an extended thoracic operation. Six patients had lung cancer, six had a mediastinal tumour and one had a mesothelioma. We retrospectively observed the postoperative clinical courses in the perioperative period and lung function results at 1 year after operation. The postoperative lung function was compared with the predicted postoperative lung function. In addition, we observed clinical symptoms and radiological findings of the follow-up period. Results: Ten (77 % ) of the cases revealed no postoperative complications, while three (23 % ) had pulmonary complications and two (15 % ) required prolonged mechanical ventilation. Diaphragm paralysis was not shown clinically and radiologically during the follow-up period. Postoperative lung function was similar to predicted postoperative lung function. Conclusion: 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.