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diaphragm plication

Matthew R Kaufman, Andrew I Elkwood, David Brown, John Cece, Catarina Martins, Thomas Bauer, Jason Weissler, Kameron Rezzadeh, Reza Jarrahy
Background Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. Methods A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome...
September 25, 2016: Journal of Reconstructive Microsurgery
S Wiesemann, B Haager, B Passlick
Unilateral elevation of the diaphragm may be due to various causes and requires further elucidation when the aetiology is unknown. Elevation of the diaphragm is often caused by diaphragmatic paralysis, either due to damage to the phrenic nerve or to the phrenic muscle. Patients typically complain of increased respiratory distress when lying down, bending or swimming. Basic diagnostic testing consists of a chest X-ray, as well as spirometry and computer tomography of the neck and chest. In many cases, no cause can be identified for the diaphragmatic paralysis...
September 2016: Zentralblatt Für Chirurgie
Eitan Podgaetz, Rafael Garza-Castillon, Rafael S Andrade
Diaphragmatic eventration and diaphragmatic paralysis are 2 entities with different etiology and pathology, and are often clinically indistinguishable. When symptomatic, their treatment is the same, with the objective to reduce the dysfunctional cephalad excursion of the diaphragm during inspiration. This can be achieved with diaphragmatic plication through the thorax or the abdomen with either open or minimally invasive techniques. We prefer the laparoscopic approach, due to its easy access to the diaphragm and to avoid pain associated with intercostal incisions and instrument use...
August 2016: Thoracic Surgery Clinics
W Windisch, B Schönhofer, F S Magnet, E Stoelben, H-J Kabitz
There are many reasons for an impairment of the diaphragmatic function potentially affecting all components of the respiratory pump. Particularly, diagnosis and treatment of unilateral and bilateral phrenic nerve paralysis are challenging. Neuromuscular disorders, trauma, iatrogenic conditions, tumor compression, but also infectious and inflammatory conditions in addition to neuralgic amyotrophy and idiopathic phrenic nerve paralysis are reasons for phrenic nerve paralysis. Primarily, diagnostic procedures include the anamnesis, physical examination, blood gas analysis, lung function testing and the diagnosis of the underlying disease...
July 2016: Pneumologie
Gwyn W Beattie, William G Dunn, Mohammed Asif
A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients with tumours involving the phrenic nerve, does prophylactic diaphragm plication improve lung function following tumour resection?' Using the reported search, 258 papers were found of which 6 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated...
September 2016: Interactive Cardiovascular and Thoracic Surgery
Mohamed Moneer ElSaegh, Nur Ismail, Joel Dunning
Elevated diaphragm can be due to diaphragmatic eventration or diaphragm paralysis. Diaphragm paralysis is a rare condition that can be congenital or acquired. Acquired diaphragmatic paralysis can result from injury to the phrenic nerve. Subsequently, there is loss of contractility of the diaphragm muscle leading to progressive atrophy and, hence, distension of the dome of the diaphragm leading to elevated right, left, or both copula of the diaphragm. Diaphragm plication aims to return the abdominal contents back to their normal position and allow for greater lung expansion by reducing the abundant diaphragmatic surface...
April 2016: Surgical Technology International
Hussam K Hamadah, Mohamed S Kabbani, Mahmoud Elbarbary, Omar Hijazi, Ghassan Shaath, Sameh Ismail, Ammar M H Qadi, Hayan AlTaweel, Abdulraouf Jijeh
: Introduction The use of ultrasound for assessing diaphragmatic dysfunction after paediatric cardiac surgery may be under-utilised. This study aimed to evaluate the role of bedside ultrasound performed by an intensivist to diagnose diaphragmatic dysfunction and the need for plication after paediatric cardiac surgery. METHODS: We carried out a retrospective cohort study on prospectively collected data of postoperative children admitted to the paediatric cardiac ICU during 2013...
May 10, 2016: Cardiology in the Young
Serdar Evman, Cagatay Tezel, Mustafa Vayvada, Serda Kanbur, Senol Urek, Volkan Baysungur, Irfan Yalçınkaya
PURPOSE: There is no data comparing different surgical techniques for diaphragmatic re-positioning for hemi-diaphragmatic eventration in adults. Our aim was to verify the potential pros and cons of two major surgical techniques in symptomatic eventration patients. METHODS: Patients undergoing thoracotomy for diaphragmatic elevation repair either by un-opened (accordion placation) or by opened (double-breasted placation) diaphragmatic technique between January 2007 and August 2013 were analyzed retrospectively, and compared in terms of operative outcomes on 12th and 24th months...
August 23, 2016: Annals of Thoracic and Cardiovascular Surgery
Ghazi Elshafie, Johanna Acosta, Andrea Aliverti, Amy Bradley, Prem Kumar, Pala Rajesh, Babu Naidu
BACKGROUND: Following diaphragmatic plication for unilateral paralysis, the effect on global chest wall function are unknown. Our hypothesis was that chest wall function would improve in both sides of the chest after plication of the paralysed side. CASE PRESENTATION: Using Optoelectronic Plethysmography, total and regional chest wall volumes were measured in one patient before and after left diaphragmatic plication. Volumes were recorded at quiet breathing. Respiratory capacity improved during quiet breathing when measured before and 6 months after surgery...
2016: Journal of Cardiothoracic Surgery
H Volkan Kara, Michael J Roach, Stafford S Balderson, Thomas A D'Amico
No abstract text is available yet for this article.
November 2015: Annals of Cardiothoracic Surgery
Ashraf Alshorbagy, Yasser Mubarak
BACKGROUND: To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood. METHODS: This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets. RESULTS: The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired)...
October 2015: Korean Journal of Thoracic and Cardiovascular Surgery
Pradeep Bhaskar, Reyaz A Lone, Ahmad Sallehuddin, Jiju John, Akhlaque N Bhat, Muhammed R K Rahmath
Diaphragmatic paralysis following phrenic nerve injury is a major complication following congenital cardiac surgery. In contrast to unilateral paralysis, patients with bilateral diaphragmatic paralysis present a higher risk group, require different management methods, and have poorer prognosis. We retrospectively analysed seven patients who had bilateral diaphragmatic paralysis following congenital heart surgery during the period from July, 2006 to July, 2014. Considerations were given to the time to diagnosis of diaphragm paralysis, total ventilator days, interval after plication, and lengths of ICU and hospital stays...
June 2016: Cardiology in the Young
Saravanan N, Ramalingam R, Subramanian H
No abstract text is available yet for this article.
July 2015: Journal of Neonatal Surgery
Serdar Özkan, Ülkü Yazıcı, Ertan Aydın, Nurettin Karaoğlanoğlu
No abstract text is available yet for this article.
April 2015: Balkan Medical Journal
Serdar Özkan, Ülkü Yazici, Ertan Aydin, Nurettin Karaoğlanoğlu
BACKGROUND: Diaphragm plication surgery is conducted to remove dyspnea, which results from mediastinal shift, atelectasia, and ventilation/perfusion dyssynchrony in lungs that occur because of an eventrated diaphragm. This study aims to determine whether diaphragm plication has any effect on respiration by analyzing the patients' changing values in the respiratory function test (RFT) after plication surgery. METHODS: Sixteen patients who underwent diaphragm plication surgery in our clinic because of plication eventration or paralysis were examined prospectively...
April 2016: Asian Journal of Surgery
Yoshinobu Ichiki, Shotaro Korehisa, Junji Kawasaki, Takayuki Hamatsu, Taketoshi Suehiro, Makiko Koike, Fumihiro Tanaka, Keizo Sugimachi
INTRODUCTION: Diaphragmatic eventration, defined as permanent elevation of the diaphragm without defects, is a rare anomaly in adults. Trauma, neoplasms, infection, and degenerative disease are the most common causes of this condition, whereas idiopathic eventration of the diaphragm is relatively infrequent. PRESENTATION OF CASE: We herein present the rare case of an 85-year-old female with idiopathic eventration of the bilateral diaphragm. The patient demonstrated a rapidly progressive course with dyspnea; therefore, thoracoscopic surgery of the unilateral diaphragm was performed...
2015: International Journal of Surgery Case Reports
Shengde Wu, Na Zang, Jin Zhu, Zhengxia Pan, Chun Wu
OBJECTIVE: This study sought to summarize the diagnostic and treatment aspects of congenital diaphragmatic eventration (CDE) in children by retrospectively analyzing their medical records to identify and understand the complications of CDE, its treatment, and to evaluate the long-term outcomes of diaphragmatic plication. METHODS: The medical records of children who received treatment for CDE from January 2000 to December 2011 at the Children's Hospital of Chongqing Medical University, China were analyzed...
July 2015: Journal of Pediatric Surgery
Yury Kozlov, Vladimir Novozhilov
PURPOSE: Thoracoscopic plication of the diaphragm is an alternative to conventional surgical treatment of diaphragmatic evisceration via thoracotomy in neonates and infants. The aim of this study is to compare results of treatment by these two methods in the past 11 years. MATERIALS AND METHODS: We studied the data of 35 neonates who underwent standard posterolateral thoracotomy (18 patients; Group I) or video-assisted thoracoscopic surgery (17 patients; Group II) for diaphragmatic plication...
April 2015: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Prabhu Dayal Sinwar
BACKGROUND: Eventration of diaphragm associated with gastric volvulus is an uncommon condition. CASE PRESENTATION: We reporting a case of a 16-year-old male having left sided diaphragmatic eventration associated with acute mesenteroaxial gastric volvulus. The patient presented with acute pain abdomen and upper abdomen fullness. Plication of left hemidiaphragm with anterior gastropexy was performed through an abdominal approach. Postoperatively the patient's recover uneventfully...
2015: International Journal of Surgery Case Reports
Joel Dunning
Diaphragm plication is a relatively common operation in thoracic surgery and can be a major benefit to patients who have suffered phrenic nerve injury and who are left short of breath as a result [1]. With the advent of video-assisted thoracoscopic surgery (VATS) many surgeons have attempted diaphragm plication endoscopically. Barriers to implementation of VATS diaphragm plication include concerns regarding initial port entry with such a high diaphragm, the technical ability to suture by VATS and concern regarding the placement of sutures to a thin diaphragm draped tightly over a spleen, liver or large intestine...
May 2015: Interactive Cardiovascular and Thoracic Surgery
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