Long-Term Follow-Up of the Functional and Physiologic Results of Diaphragm Plication in Adults With Unilateral Diaphragm Paralysis

Is video-assisted thoracoscopic diaphragmatic plication a widespread technique for diaphragmatic hernia in adults?: Review of the literature and results of a national survey

“…Only one cohort study was identified, 4 and the others consisted of case series and clinical cases. The most voluminous series was that of Freeman et al, 12 with 41 DP cases (30 by VATSthoracoscopy, and 11 by thoracotomy). After their review, Gazala et al concluded that thoracotomy DP or thoracoscopy DP appear to be effective in improving respiratory function and symptoms in patients with DH; although, the results lack comprehensive analytical studies, therefore, they must be treated with caution, and they emphasize the need for quality studies focused mainly on results and long-term quality of life for patients who have undergone surgery.…”

“…2 0 1 4 ; 9 2 ( 7 ) : 4 5 3 -4 6 2 In our review of the literature, we have not found any clinical trial or meta-analysis related to this issue. The publication of Freeman et al 12 is a cohort study comparing DH patients who did not undergo surgery (7 cases), with another group of patients undergoing DP by thoracotomy (11 cases) and VATS (30 cases). Due to the limited cases and design, it cannot be considered as level of evidence IIb.…”

“…1,7 At present, although there are few publications and few cases in the literature, DP with minimally invasive techniques is considered the treatment of choice; it is safe and effective for correcting clinical and spirometric defects secondary to DH. 1,8,12 However, many surgeons are unaware of this unusual procedure; some even continue using thoracotomy (as performed for over half a century), without incorporating the practical benefits of minimally invasive surgery. 13,14 These latter observations, also mentioned by other authors, seem to fit the reality in Spain.…”

Paralysis and Eventration of the Diaphragm

“…Fonksiyonel rezidüel kapasitede %35 oranında düşme görülür. VATS plikasyonda, kısa ve uzun dönem takiplerde solunum fonksiyon parametrelerinde de ciddi düzelmeler bildirilmiştir (15)(16)(17). Son yapılan dokuz vakadan oluşan ve değişik yaklaşımların uygulandığı bir çalışmada, plikasyon sonrası tidal volümlerin arttığı, solunum sıklığının azaldığı ve maksimal eksersiz kapasitenin ise değiş-meden kaldığı gösterilmiştir (18).…”

Unilateral Diaphragmatic Paralysis in a Diabetic Patient: A Case of Trepopnea

“…When there is functional limitation, surgical plication remains the gold standard 9 . Diaphragm resections and video assisted minimally invasive surgery have also been effective 9,23 . In one series of 41 patients, 30 had the video assisted procedure and the rest had thoracotomy.…”