Simultaneous lung metastatic resection and diaphragmatic plication for dyspnea after combined resection of phrenic nerve for thymoma and metastatic resection

Diaphragmatic paralysis due to phrenic nerve injury is an occasional complication of cardiothoracic surgery. Although diaphragmatic plication is widely used to treat patients with severe irreversible symptoms, its surgical indication and timing remain controversial. Here, we present a rare case of diaphragmatic paralysis in a 65-year-old woman who underwent cardiac surgery and whose respiratory symptoms worsened despite >5 years of conservative management. Consequently, she underwent diaphragmatic plication using an endostapler to resect the redundant diaphragm, followed by over-suturing of all staple lines. She was discharged without any complications and her symptoms and chest radiography and spirometry results improved postoperatively.

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Bilateral phrenic-nerve paralysis treated by thoracoscopic diaphragmatic plication in a neonate

Pediatric Surgery International ◽

10.1007/s00383-002-0737-z ◽

2003 ◽

Vol 19 (1) ◽

pp. 79-81 ◽

Cited By ~ 7

Author(s):

Masaki Shimizu

Keyword(s):

Phrenic Nerve ◽

Nerve Paralysis ◽

Phrenic Nerve Paralysis ◽

Diaphragmatic Plication

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Combination of diaphragmatic plication with major abdominal surgery in patients with phrenic nerve palsy

Surgery ◽

10.1016/j.surg.2004.05.052 ◽

2005 ◽

Vol 137 (2) ◽

pp. 243-245 ◽

Cited By ~ 5

Author(s):

Vassilios Smyrniotis ◽

Nikolaos Arkadopoulos ◽

Georgia Kostopanagiotou ◽

Evangelos Gamaletsos ◽

Lida Pistioli ◽

...

Keyword(s):

Abdominal Surgery ◽

Phrenic Nerve ◽

Nerve Palsy ◽

Major Abdominal Surgery ◽

Phrenic Nerve Palsy ◽

Diaphragmatic Plication

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Diaphragmatic Plication for Acquired Phrenic Nerve Injury after Congenital Cardiac Surgeries

The Egyptian Cardiothoracic Surgeon ◽

10.35810/ects.v2i1.117 ◽

2020 ◽

Vol 2 (1) ◽

pp. 33-38

Author(s):

Osman Al-Radi

Keyword(s):

Nerve Injury ◽

Phrenic Nerve ◽

Ventilatory Support ◽

Diaphragmatic Paralysis ◽

Diaphragmatic Dysfunction ◽

Common Procedure ◽

Phrenic Nerve Injury ◽

Diaphragmatic Plication ◽

Initial Surgery ◽

The Mean

Background: Phrenic nerve injury and diaphragmatic dysfunction are common after pediatric cardiac surgery leading to failure to wean from ventilatory support. Diaphragmatic plication is the standard management of diaphragmatic paralysis. The aim of this retrospective study is to review our experience with diaphragmatic plication and its effect on the operative outcome. Methods: This retrospective cohort study included all patients who underwent diaphragmatic plication from June 2010 to June 2017. Seventy-six patients (2.87%) had unilateral diaphragmatic paralysis following 2646 congenital cardiac procedures. Sixty-four patients (2.4%) underwent diaphragmatic plication. Results: The median age for the patients who had plication was 2.75 months (range 0.5- 36) and 3.7 months (range 0.66 to 123) for non-plicated patients. Thirty-six were males (56.25%), and the most common procedure associated with diaphragmatic plication was modified Blalock Taussig Shunt (n= 13; 20.3%). Left-sided diaphragmatic plication was performed in 44 patients (68.7%). The mean time between the primary surgery and diaphragm plication was 6.42±4.51 days. The mean ventilation period before plication was 4.93±3.71 days, and post plication ventilation median time was 2.11±1.82 days. Two patients (3.1%) required tracheostomy for prolonged respiratory insufficiency. One patient (1.6%) needed surgical revision, and two patients (3.1%) had their diaphragmatic plication during the initial surgery. Conclusion: Diaphragmatic plication is an effective procedure in the management of postoperative diaphragmatic paralysis. We recommend early plication for patients with symptomatic diaphragmatic paralysis causing prolonged ventilation

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