Surgical correction of acquired unilateral diaphragmatic paralysis by plication technique
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Second Department of Propedeutic Surgery, National and Kapodistrian University of Athens Medical School, “Laiko” General Hospital, Athens, Greece
Respiratory Intensive Care Unit, Athens Chest Hospital “Sotiria”, Athens, Greece
Department of Pathophysiology, National and Kapodistrian University of Athens Medical School, “Laiko” General Hospital, Athens, Greece
Respiratory Department, “Laiko” General Hospital, Athens, Greece
Periklis Tomos   

Thoracic Surgery, Second Department of Propedeutic Surgery, University of Athens Medical School, “Laiko” General Hospital 17 Agiou Thoma St., 11527, Athens, Greece
Pneumon 2013;26(2):179–183
Acquired diaphragmatic paralysis may compromise lung mechanics and cause dyspnoea and/or lead to respiratory failure in the long term. A 76 year-old female patient presented with progressive worsening of dyspnoea and spirometric indices, and imaging studies revealed elevation of the left hemidiaphragm. Surgical correction was carried out by diaphragmatic plication technique, through a mini-thoracotomy approach. Immediate alleviation (within days) of her symptoms was observed, while improvement of radiological and pulmonary function tests occurred some weeks later.
Riley EA. Idiopathic diaphragmatic paralysis; a report of eight cases. Am J Med 1962;32:404–416.
Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: a review of the literature. Ann Thorac Surg 2010;89:2146–2150.
Dempers JJ, Bezuidenhout J, Schneider JW, Van Rensburg MJ. Tuberculosis and phrenic nerve destruction. S Afr Med J 2007;97:572–573.
Goussard P, Gie RP, Kling S, Andronikou S, Janson JT, Roussouw GJ. Phrenic nerve palsy in children associated with confirmed intrathoracic tuberculosis: diagnosis and clinical course. Pediatr Pulmonol 2009;44:345–350.
McCool FD, Tzelepis GE. Dysfunction of the diaphragm. N Engl J Med 2012;366:932–942.
Freeman RK, Van Woerkom J, Vyverberg A, Ascioti AJ. Longterm follow-up of the functional and physiologic results of diaphragm plication in adults with unilateral diaphragm paralysis. Ann Thorac Surg 2009;88:1112–1117.
Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest 2008;133:737–743.
Gayan-Ramirez G, Gosselin N, Troosters T, Bruyninckx F, Gosselink R, Decramer M. Functional recovery of diaphragm paralysis: a long-term follow-up study. Respir Med 2008;102:690–698.
Graham DR, Kaplan D, Evans CC, Hind CR, Donnelly RJ. Diaphragmatic plication for unilateral diaphragmatic paralysis: a 10-year experience. Ann Thorac Surg 1990;49:248–251.
Versteegh MI, Braun J, Voigt PG, et al. Diaphragm plication in adult patients with diaphragm paralysis leads to long-term improvement of pulmonary function and level of dyspnea. Eur J Cardiothorac Surg 2007;32:449–456.
Higgs SM, Hussain A, Jackson M, Donnelly RJ, Berrisford RG. Long term results of diaphragmatic plication for unilateral diaphragm paralysis. Eur J Cardiothorac Surg 2002;21:294–297.
Celik S, Celik M, Aydemir B, Tunckaya C, Okay T, Dogusoy I. Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis. J Cardiothorac Surg 2010;5:111.
Maxson T, Robertson R, Wagner CW. An improved method of diaphragmatic plication. Surg Gynecol Obstet 1993;177:620–1.
Di Giorgio A, Cardini CL, Sammartino P, Sibio S, Naticchioni E. Dual-layer sandwich mesh repair in the treatment of major diaphragmatic eventration in an adult. J Thorac Cardiovasc Surg 2006;132:187–189.
Freeman RK, Wozniak TC, Fitzgerald EB. Functional and physiologic results of video-assisted thoracoscopic diaphragm plication in adult patients with unilateral diaphragm paralysis. Ann Thorac Surg 2006;81:1853–1857.
Hwang Z, Shin JS, Cho YH, Sun K, Lee IS. A simple technique for the thoracoscopic plication of the diaphragm. Chest 2003;124:376–378.
Moon SW, Wang YP, Kim YW, Shim SB, Jin W. Thoracoscopic plication of diaphragmatic eventration using endostaplers. Ann Thorac Surg 2000;70:299–300.
Kizilcan F, Tanyel FC, Hi\ccsönmez A, Büyükpamuk\ccu N. The long-term results of diaphragmatic plication. J Pediatr Surg 1993;28:42–44.
Takeda S, Nakahara K, Fujii Y, Matsumura A, Minami M, Matsuda H. Effects of diaphragmatic plication on respiratory mechanics in dogs with unilateral and bilateral phrenic nerve paralyses. Chest 1995;107:798–804.
Hüttl TP, Wichmann MW, Reichart B, Geiger TK, Schildberg FW, Meyer G. Laparoscopic diaphragmatic plication: long-term results of a novel surgical technique for postoperative phrenic nerve palsy. Surg Endosc 2004;18:547–551.
Groth SS, Rueth NM, Kast T, et al. Laparoscopic diaphragmatic plication for diaphragmatic paralysis and eventration: an objective evaluation of short-term and midterm results. J Thorac Cardiovasc Surg 2010;139:1452–1456.
Kuniyoshi Y, Yamashiro S, Miyagi K, Uezu T, Arakaki K, Koja K. Diaphragmatic plication in adult patients with diaphragm paralysis after cardiac surgery. Ann Thorac Cardiovasc Surg 2004;10:160–166.
Phadnis J, Pilling JE, Evans TW, Goldstraw P. Abdominal compartment syndrome: a rare complication of plication of the diaphragm. Ann Thorac Surg 2006;82:334–336.
Rogers ML. Early and long-term complaints following videoassisted thoracoscopic surgery: evaluation in 173 patients. Eur J Cardiothorac Surg 2000;18:737–738.