In appropriately selected patients diaphragm plication improves quality of life by alleviating dyspnea and allowing patients to return to their routine activities. Many plication techniques exist, but the optimal surgical approach remains unclear. We report our experience with a minimally invasive radial diaphragm plication technique. It offers 2 distinct advantages: (1) suture placement avoids the phrenic nerve fibers, allowing for potential nerve recovery, and (2) the interrupted radial sutures improve the distribution of tension along the flaccid muscle and may achieve a more durable repair.
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http://dx.doi.org/10.1016/j.athoracsur.2021.11.037 | DOI Listing |
Kyobu Geka
October 2024
Department of Cardiovascular Surgery, Saga-ken Medical Centre Koseikan, Saga, Japan.
When respiratory failure occurs due to intractable pleural effusion, frequent thoracentesis is necessary. We herein report a patient who underwent diaphragmoplasty and pleuroperitoneal shunt for refractory pleural effusion after cardiac surgery. The patient was an 82-year-old man with a history of tricuspid valve replacement for tricuspid regurgitation 9-years ago.
View Article and Find Full Text PDFCureus
October 2024
Department of Surgery, Zen Hospital, Mumbai, IND.
Diaphragmatic eventration (DE) is characterized by abnormal diaphragm elevation resulting from muscle weakness or thinning. It may be congenital or acquired, affecting both pediatric and adult populations, and is associated with symptoms such as dyspnea and chest pain. Although DE is infrequent, with a higher incidence on the left side, it has traditionally been managed through invasive surgical techniques.
View Article and Find Full Text PDFJ Med Case Rep
October 2024
Dept. of General Surgery, Anadolu Medical Center, Kocaeli, Turkey.
Background: Chilaiditi's sign is an incidental radiographic finding, associated with intestinal disposition located between liver and right diaphragm. It is considered as an acquired rather than a congenital condition and the prevalence ranges from 1.18% to 2.
View Article and Find Full Text PDFJ Clin Med
September 2024
Department of Thoracic Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA.
With the paradigm shift in minimally invasive surgery from the video-assisted thoracoscopic platform to the robotic platform, thoracic surgeons are applying the new technology through various commonly practiced thoracic surgeries, striving to improve patient outcomes and reduce morbidity and mortality. This review will discuss the updates in lung resections, lung transplantation, mediastinal surgeries with a focus on thymic resection, rib resection, tracheal resection, tracheobronchoplasty, diaphragm plication, esophagectomy, and paraesophageal hernia repair. The transition from open surgery to video-assisted thoracoscopic surgery (VATS) to now robotic video-assisted thoracic surgery (RVATS) allows complex surgeries to be completed through smaller and smaller incisions with better visualization through high-definition images and finer mobilization, accomplishing what might be unresectable before, permitting shorter hospital stay, minimizing healing time, and encompassing broader surgical candidacy.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
October 2024
Department of Thoracic Surgery, St Luke's International Hospital, Tokyo, Japan.
Symptomatic unilateral diaphragmatic eventration require surgical intervention. A 56-year-old woman complained of dyspnoea on exertion and was noted to have left diaphragm elevation on chest radiographs. Dynamic magnetic resonance imaging showed paradoxical movement of the left diaphragm.
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