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Minimally Invasive Plication of the Diaphragm: A Single-Center Prospective Study.
- Source :
-
Innovations (Philadelphia, Pa.) [Innovations (Phila)] 2021 Jul-Aug; Vol. 16 (4), pp. 343-349. Date of Electronic Publication: 2021 Jun 15. - Publication Year :
- 2021
-
Abstract
- Objective: Plication of the diaphragm is a life-changing procedure for patients affected by diaphragm paralysis. Traditionally, this procedure is performed through a thoracotomy. Access to the diaphragm via this incision is poor and the indications for surgery are limited to patients who can actually sustain such an invasive approach and associated morbidities. A minimally invasive approach was developed to improve the surgical management of diaphragm paralysis.<br />Methods: Patients underwent minimally invasive diaphragm plication either by video-assisted or robotic surgery through a 3-port technique with CO <subscript>2</subscript> insufflation. Patients were followed at the routine 6-week clinic and also by telephone consultation 6 to 12 months postoperatively. Data were collected on postoperative complications, postoperative pain or numbness, symptomatic improvement, and change to quality of life following surgery.<br />Results: Forty-eight patients underwent 49 minimally invasive diaphragm plication. Median postoperative length of hospital stay was 4 days (range: 2 to 34 days) and there were no cases of mortality. Mean reduction in Medical Research Council dyspnea score per patient was 2.2 points (mode: 3 points). Twenty-eight patients (77.8%) reported a significant symptomatic improvement enabling improvements in quality of life, and 97.2% ( n = 35) were satisfied with the surgical outcome.<br />Conclusions: Minimally invasive diaphragm plication is a safe procedure associated with prompt postoperative recovery. It is effective at reducing debilitating dyspnea and improving quality of life.
Details
- Language :
- English
- ISSN :
- 1559-0879
- Volume :
- 16
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Innovations (Philadelphia, Pa.)
- Publication Type :
- Academic Journal
- Accession number :
- 34130535
- Full Text :
- https://doi.org/10.1177/15569845211011583