HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Jérôme Mouroux Nicolas Venissac Francesco Leo Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mouroux, J. Articles by Guillot, F. Search for Related Content PubMed PubMed Citation Articles by Mouroux, J. Articles by Guillot, F. Related Collections Diaphragm

Ann Thorac Surg 2005;79:308-312
© 2005 The Society of Thoracic Surgeons

---

Original article: General thoracic

Surgical Treatment of Diaphragmatic Eventration Using Video-Assisted Thoracic Surgery: A Prospective Study

Service de Chirurgie Thoracique, CHU de Nice, Hôpital Pasteur, Nice, France

Accepted for publication June 11, 2004.

^* Address reprint requests to Dr Alifano, Chirurgia Toracica, Ospedale Maggiore, Largo B. Nigrisoli, 2, 40100 Bologna, Italy (E-mail: marcoalifano{at}yahoo.com).

BACKGROUND: This study seeks to evaluate results regarding the repair of diaphragmatic eventration using video-assisted thoracic surgery (VATS).

METHODS: We performed a prospective observational study including patients referred to us for surgical treatment of diaphragmatic eventration during a 12-year period. Clinical, radiologic, and functional data were prospectively recorded. VATS was performed with two thoracoports and a 4-cm mini-thoracotomy. Diaphragmatic plication was performed using two nonresorbable running sutures from periphery to the cardio-phrenic angle. Follow-up data (clinical examination, chest roentgenogram, lung function tests at 3, 6, 12 months, and annually thereafter) were also prospectively recorded.

RESULTS: Twelve patients (4 male adults, mean age 57.7 ± 14.8 years) were operated on between 1992 and 2003. The left side was involved in 8 patients and the mean height of diaphragm elevation was 7.5 ± 1.8 cm. All patients experienced symptoms related to the disease; in 2 patients the operation was carried out to achieve weaning from mechanical ventilation. The etiologic mechanism could be identified in 11 out of 12 patients (trauma, n = 9; Charcot-Marie disease, n = 1; calcified para-aortic nodes, n = 1). Mean operative time, drainage output, and hospital stay were 77 ± 15 minutes, 0.8 ± 04 L, and 3.4 ± 0.7 days, respectively. No mortality was observed; 1 patient experienced postoperative pneumonia, which was treated using antibiotics. All patients experienced amelioration of symptoms and long-term lung function tests revealed a marked improvement of both the forced volume capacity and the forced expiratory volume at 1 second. No relapses were observed at follow-up chest roentgenogram.

CONCLUSIONS: Treatment using VATS is a safe and effective alternative to conventional surgery. Functional improvement persists at long-term follow-up.

This article has been cited by other articles:

				D. McCool, N. Ayas, R. Brown, S. H. Loring, L. M.A. Heunks, R. P.N. Dekhuijzen, E. Fan, D. M. Needham, F. Leo, L. Spaggiari, et al. Mechanical ventilation and disuse atrophy of the diaphragm. N. Engl. J. Med., July 3, 2008; 359(1): 89 - 90. [Full Text] [PDF]

				M. I. M. Versteegh and A. T. Jouk Tjien Diaphragm plication in adult patients with diaphragm paralysis MMCTS, December 17, 2007; 2007(1217): 2568. [Abstract] [Full Text] [PDF]

				A. Di Giorgio, C. L. Cardini, P. Sammartino, S. Sibio, and E. Naticchioni Dual-layer sandwich mesh repair in the treatment of major diaphragmatic eventration in an adult J. Thorac. Cardiovasc. Surg., July 1, 2006; 132(1): 187 - 189. [Full Text] [PDF]