Diaphragmatic paralysis surgery: Difference between revisions
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* Nerve surgery | * Nerve surgery via [[neurolysis]], nerve grafting<ref name="pmid25868155">{{cite journal |vauthors=Kaufman MR, Elkwood AI, Aboharb F, Cece J, Brown D, Rezzadeh K, Jarrahy R |title=Diaphragmatic reinnervation in ventilator-dependent patients with cervical spinal cord injury and concomitant phrenic nerve lesions using simultaneous nerve transfers and implantable neurostimulators |journal=J Reconstr Microsurg |volume=31 |issue=5 |pages=391–5 |date=June 2015 |pmid=25868155 |doi=10.1055/s-0035-1549159 |url=}}</ref> | ||
*The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either: | *The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either: | ||
**[Indication 1] | **[Indication 1] | ||
Revision as of 19:06, 23 February 2018
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Surgical intervention is not recommended for the management of [disease name].
OR
Surgery is not the first-line treatment option for patients with [disease name]. Surgery is usually reserved for patients with either [indication 1], [indication 2], and [indication 3]
OR
The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either [indication 1], [indication 2], and/or [indication 3].
OR
The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
Surgery is the mainstay of treatment for [disease or malignancy].
Indications
Unilateral diaphragmatic paralysis
- Surgery is not the first-line treatment option for patients with unilateral diaphragmatic paralysis . Surgery is usually reserved for patients with either:[1][2]
- Dyspnea in strenous physical activity
- Underlying severe pulmonary disease
bilateral diaphragmatic paralysis
- Nerve surgery via neurolysis, nerve grafting[3]
- The mainstay of treatment for [disease name] is medical therapy. Surgery is usually reserved for patients with either:
- [Indication 1]
- [Indication 2]
- [Indication 3]
Surgery
Unilateral diaphragmatic paralysi
- Surgical plication of the involved hemidiaphragm:[4][5]
- It is performed via thoracotomy, video-assisted thoracoscopic surgery (VATS) or laparoscopy
- Creating folds in the hemidiaphragm and suturing them reduce mobilty of involved hemidiaphragm.
- Following surgery, the involved diaphragam does not paradoxically moved upward into the thorax during inspiration and ventilation will be improved in this way.
- The feasibility of surgery depends on the stage of [malignancy] at diagnosis.
OR
- Surgery is the mainstay of treatment for [disease or malignancy].
Contraindications
Morbid obesity is contraindication to surgical plication[6]
References
- ↑ Versteegh MI, Braun J, Voigt PG, Bosman DB, Stolk J, Rabe KF, Dion RA (September 2007). "Diaphragm plication in adult patients with diaphragm paralysis leads to long-term improvement of pulmonary function and level of dyspnea". Eur J Cardiothorac Surg. 32 (3): 449–56. doi:10.1016/j.ejcts.2007.05.031. PMID 17658265.
- ↑ Ciccolella DE, Daly BD, Celli BR (September 1992). "Improved diaphragmatic function after surgical plication for unilateral diaphragmatic paralysis". Am. Rev. Respir. Dis. 146 (3): 797–9. doi:10.1164/ajrccm/146.3.797. PMID 1519867.
- ↑ Kaufman MR, Elkwood AI, Aboharb F, Cece J, Brown D, Rezzadeh K, Jarrahy R (June 2015). "Diaphragmatic reinnervation in ventilator-dependent patients with cervical spinal cord injury and concomitant phrenic nerve lesions using simultaneous nerve transfers and implantable neurostimulators". J Reconstr Microsurg. 31 (5): 391–5. doi:10.1055/s-0035-1549159. PMID 25868155.
- ↑ Hüttl TP, Wichmann MW, Reichart B, Geiger TK, Schildberg FW, Meyer G (March 2004). "Laparoscopic diaphragmatic plication: long-term results of a novel surgical technique for postoperative phrenic nerve palsy". Surg Endosc. 18 (3): 547–51. doi:10.1007/s00464-003-8127-8. PMID 15108692.
- ↑ Wright CD, Williams JG, Ogilvie CM, Donnelly RJ (August 1985). "Results of diaphragmatic plication for unilateral diaphragmatic paralysis". J. Thorac. Cardiovasc. Surg. 90 (2): 195–8. PMID 3927067.
- ↑ Petrovic M, Lahrmann H, Pohl W, Wanke T (February 2009). "Idiopathic diaphragmatic paralysis--satisfactory improvement of inspiratory muscle function by inspiratory muscle training". Respir Physiol Neurobiol. 165 (2–3): 266–7. doi:10.1016/j.resp.2008.11.010. PMID 19111633.