Phrenic nerve reconstruction in complete video-assisted thoracic surgery

Kawashima, Shinichi; Kohno, Tadasu; Fujimori, Sakashi; Yokomakura, Naoya; Ikeda, Takeshi; Harano, Takashi; Suzuki, Souichiro; Iida, Takahiro; Sakai, Emi

doi:10.1093/icvts/ivu290

Cited by 19 publications

(9 citation statements)

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“…Furthermore, surgical intervention for PNP, resulting in significantly improved pulmonary function in comparison with nonsurgical treatment, has been reported [6]. In another report, 5 of 6 patients showed improved movement of the diaphragm after reconstruction of the phrenic nerve after intraoperative injury [5].…”

Section: Commentmentioning

confidence: 98%

“…Reconstruction of the injured nerve may be the only curative treatment option for PNP. Surgical reinnervation by neurolysis, nerve grafting, and nerve transfer have been reported, but in a limited number of cases [4,5]. A reinnervation success rate of 66.7% was reported with the use of neurolysis and nerve transposition after unilateral PNP [4].…”

Section: Commentmentioning

confidence: 99%

“…The phrenic nerve can be reconstructed by several surgical techniques, including microscopic reconstruction [4] and video-assisted thoracoscopic surgery [5]. We chose a microscopic approach because thoracotomy provided an adequate working space.…”

Section: Commentmentioning

confidence: 99%

See 2 more Smart Citations

Phrenic Nerve Reconstruction and Bilateral Diaphragm Plication After Lobectomy

Shinohara

Yamada

Ueda

et al. 2017

The Annals of Thoracic Surgery

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Section: Commentmentioning

confidence: 98%

Section: Commentmentioning

confidence: 99%

See 1 more Smart Citation

Phrenic Nerve Reconstruction and Bilateral Diaphragm Plication After Lobectomy

Shinohara

Yamada

Ueda

et al. 2017

The Annals of Thoracic Surgery

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“…When occurring in the mediastinum, they can involve various structures such as nerves . Thus, debulking surgery can be followed by reconstructive techniques . The peculiar neurosurgical strategy we performed consisted of the transplantation of contralateral nerve fibers.…”

Section: Introductionmentioning

confidence: 99%

Importance of muldisciplinary management of giant mediastinal sarcoma: A case report with phrenic nerve reconstruction

et al. 2020

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Primary synovial sarcoma is a soft tissue tumor which originates from synoviallike undeveloped mesenchymal structures. Here, we report the case of a giant mediastinal sarcoma in a 41-year-old female patient. After diagnosis, she underwent neoadjuvant chemotherapy. Due to its low efficacy, we collegially decided to undergo cytoreductive debulking surgery. The mass invaded the phrenic nerve bilaterally and its excision caused a severe lesion of the left nerve and a partial impairment of the right one. Thus, plastic surgeons decided to reconstruct the right phrenic nerve employing the contralateral remaining fibers. The invasiveness of this tumor, its difficult removal, histological profile and the peculiar technique to preserve diaphragmatic function classify this case as very rare. The therapeutic strategy was based on interdisciplinary teamwork which comprised several specialists' opinions. Our strategy allowed us to pursue the challenging objective to give a young woman with a severe diagnosis the best possible chance of achieving a good quality of life. To the best of our knowledge, this phrenic nerve reconstructive technique is very rare and has not previously been reported in the literature. The report emphasizes that it is possible to deal with an apparently impossible case through a collaborative approach involving several different medical specialist professionals.

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“…С развитием торакоскопического метода стал актуальным данный вариант решения проблемы релаксации диафрагмы при опухолевом поражении диафрагмального нерва. В 2015 г. опубликованы успешные результаты 6 случаев торакоскопической одномоментной реконструкции диафрагмального нерва после удаления опухоли средостения [39]. У всех больных в данном исследовании до операции не наблюдали признаков нарушения работы диафрагмы, и по сути была произведена резекция функционирующего диафрагмального нерва в едином блоке с опухолью.…”

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