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Minimally Invasive Plication of the Diaphragm: A Single-Center Prospective Study
- Source :
- Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery. 16:343-349
- Publication Year :
- 2021
- Publisher :
- SAGE Publications, 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. Methods Patients underwent minimally invasive diaphragm plication either by video-assisted or robotic surgery through a 3-port technique with CO2 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. 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. 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.
- Subjects :
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
Diaphragm paralysis
medicine.medical_treatment
Diaphragm
Single Center
phrenic nerve palsy
robotic surgery
medicine
Humans
Robotic surgery
Prospective Studies
Thoracotomy
Prospective cohort study
Referral and Consultation
Phrenic Nerve Palsy
VATS plication
Thoracic Surgery, Video-Assisted
business.industry
General Medicine
Telephone
diaphragm paralysis
Surgery
Diaphragm (structural system)
Treatment Outcome
Diaphragm plication
Quality of Life
Cardiology and Cardiovascular Medicine
business
diaphragm plication
Subjects
Details
- ISSN :
- 15590879 and 15569845
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
- Accession number :
- edsair.doi.dedup.....a5afd7d2938db2a23573de010c54fabd