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Difficult Decisions in Thoracic Surgery pp 499–509Cite as

Diaphragmatic Plication for Eventration

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Part of the book series: Difficult Decisions in Surgery: An Evidence-Based Approach ((DDSURGERY,volume 1))

Abstract

Diaphragmatic eventration is a congenital defect of the muscular portion of a hemidiaphragm that eventually leads to hemidiaphragm elevation and dysfunction. The clinical diagnosis is established solely by hemidiaphragmatic elevation of unknown etiology on imaging studies. The clinical presentation of symptomatic diaphragmatic eventration and paralysis may be indistinguishable and diaphragmatic plication is the treatment of choice for both conditions.

Minimally invasive diaphragm plication techniques are effective alternatives to open transthoracic plication and result in significant improvement in dyspnea and quality of life in appropriately selected patients.

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References

  1. Deslauriers J. Eventration of the diaphragm. Chest Surg Clin N Am. 1998;8(2):315–30.

    CAS  PubMed  Google Scholar 

  2. Chin EF, Lynn RB. Surgery of eventration of the diaphragm. J Thorac Surg. 1956;32(1):6–14.

    CAS  PubMed  Google Scholar 

  3. Christensen P. Eventration of the diaphragm. Thorax. 1959;14:311–9.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. McNamara JJ, Paulson DL, Urschel Jr HC, Razzuk MA. Eventration of the diaphragm. Surgery. 1968;64(6):1013–21.

    CAS  PubMed  Google Scholar 

  5. Riley EA. Idiopathic diaphragmatic paralysis; a report of eight cases. Am J Med. 1962;32:404–16.

    Article  CAS  PubMed  Google Scholar 

  6. Efthimiou J, Butler J, Woodham C, Benson MK, Westaby S. Diaphragm paralysis following cardiac surgery: role of phrenic nerve cold injury. Ann Thorac Surg. 1991;52(4):1005–8.

    Article  CAS  PubMed  Google Scholar 

  7. Thomas TV. Nonparalytic eventration of the diaphragm. J Thorac Cardiovasc Surg. 1968;55(4):586–93.

    CAS  PubMed  Google Scholar 

  8. Thomas TV. Congenital eventration of the diaphragm. Ann Thorac Surg. 1970;10(2):180–92.

    Article  CAS  PubMed  Google Scholar 

  9. Shah-Mirany J, Schmitz GL, Watson RR. Eventration of the diaphragm. Physiologic and surgical significance. Arch Surg. 1968;96(5):844–50.

    Article  CAS  PubMed  Google Scholar 

  10. Allen SM, Hunt B, Green M. Fall in vital capacity with posture. Br J Dis Chest. 1985;79(3):267–71.

    Article  CAS  PubMed  Google Scholar 

  11. McCredie M, Lovejoy FW, Kaltreider NL. Pulmonary function in diaphragmatic paralysis. Thorax. 1962;17:213–7.

    Article  PubMed Central  Google Scholar 

  12. Clague HW, Hall DR. Effect of posture on lung volume: airway closure and gas exchange in hemidiaphragmatic paralysis. Thorax. 1979;34(4):523–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Gould L, Kaplan S, McElhinney AJ, Stone DJ. A method for the production of hemidiaphragmatic paralysis. Its application to the study of lung function in normal man. Am Rev Respir Dis. 1967;96(4):812–4.

    CAS  PubMed  Google Scholar 

  14. Wynn-Willaims N. Hemidiaphragmatic paralysis and paresis of unknown aetiology without any marked rise in level. Thorax. 1954;9:299–303.

    Article  Google Scholar 

  15. Alexander C. Diaphragm movements and the diagnosis of diaphragmatic paralysis. Clin Radiol. 1966;17(1):79–83.

    Article  CAS  PubMed  Google Scholar 

  16. Gibson GJ. Diaphragmatic paresis: pathophysiology, clinical features, and investigation. Thorax. 1989;44(11):960–70.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  17. Gierada DS, Slone RM, Fleishman MJ. Imaging evaluation of the diaphragm. Chest Surg Clin N Am. 1998;8(2):237–80.

    CAS  PubMed  Google Scholar 

  18. Houston JG, Fleet M, Cowan MD, McMillan NC. Comparison of ultrasound with fluoroscopy in the assessment of suspected hemidiaphragmatic movement abnormality. Clin Radiol. 1995;50(2):95–8.

    Article  CAS  PubMed  Google Scholar 

  19. Slone RM, Gierada DS. Radiology of pulmonary emphysema and lung volume reduction surgery. Semin Thorac Cardiovasc Surg. 1996;8(1):61–82.

    CAS  PubMed  Google Scholar 

  20. Morrison JMW. Eventration of the diaphragm due to unilateral phrenic nerve paralysis. Arch Radiol Electrother. 1923;28:72–5.

    Article  Google Scholar 

  21. Curtis JJ, Nawarawong W, Walls JT, Schmaltz RA, Boley T, Madsen R, et al. Elevated hemidiaphragm after cardiac operations: incidence, prognosis, and relationship to the use of topical ice slush. Ann Thorac Surg. 1989;48(6):764–8.

    Article  CAS  PubMed  Google Scholar 

  22. Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest. 2008;133(3):737–43.

    Article  PubMed  Google Scholar 

  23. 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(5):690–8.

    Article  PubMed  Google Scholar 

  24. 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(3):160–6.

    PubMed  Google Scholar 

  25. Simansky DA, Paley M, Refaely Y, Yellin A. Diaphragm plication following phrenic nerve injury: a comparison of paediatric and adult patients. Thorax. 2002;57(7):613–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. 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(2):248–51; discussion 252.

    Article  CAS  PubMed  Google Scholar 

  27. Calvinho P, Bastos C, Bernardo JE, Eugenio L, Antunes MJ. Diaphragmatic eventration: long term follow up and results of open chest plicature. Eur J Cardiothorac Surg. 2009;36(5):883–7.

    Article  PubMed  Google Scholar 

  28. Wright CD, Williams JG, Ogilvie CM, Donnelly RJ. Results of diaphragmatic plication for unilateral diaphragmatic paralysis. J Thorac Cardiovasc Surg. 1985;90(2):195–8.

    CAS  PubMed  Google Scholar 

  29. 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(2):294–7.

    Article  PubMed  Google Scholar 

  30. Versteegh MI, Braun J, Voigt PG, Bosman DB, Stolk J, Rabe KF, 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(3):449–56.

    Article  PubMed  Google Scholar 

  31. Schwartz MZ, Filler RM. Plication of the diaphragm for symptomatic phrenic nerve paralysis. J Pediatr Surg. 1978;13(3):259–63.

    Article  CAS  PubMed  Google Scholar 

  32. Maxson T, Robertson R, Wagner CW. An improved method of diaphragmatic plication. Surg Gynecol Obstet. 1993;177(6):620–1.

    CAS  PubMed  Google Scholar 

  33. 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(1):187–9.

    Article  PubMed  Google Scholar 

  34. Ciccolella DE, Daly BD, Celli BR. Improved diaphragmatic function after surgical plication for unilateral diaphragmatic paralysis. Am Rev Respir Dis. 1992;146(3):797–9.

    Article  CAS  PubMed  Google Scholar 

  35. Ribet M, Linder JL. Plication of the diaphragm for unilateral eventration or paralysis. Eur J Cardiothorac Surg. 1992;6(7):357–60.

    Article  CAS  PubMed  Google Scholar 

  36. Mouroux J, Venissac N, Leo F, Ailfano M, Guillot F. Surgical treatment of diaphragmatic eventration using video-assisted thoracic surgery: a prospective study. Ann Thorac Surg. 2005;79(1):308–12.

    Article  PubMed  Google Scholar 

  37. Mouroux J, Padovani B, Poirier NC, Benchimol D, Bourgeon A, Deslauriers J, et al. Technique for the repair of diaphragmatic eventration. Ann Thorac Surg. 1996;62(3):905–7.

    Article  CAS  PubMed  Google Scholar 

  38. 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(5):1853–7; discussion 1857.

    Article  PubMed  Google Scholar 

  39. Freeman RK, Woerkom JV, Vyverberg A, Ascioti AJ. Long-term follow up of the functional and physiologic results of diaphragm plication in adults with unilateral diaphragm paralysis. Ann Thorac Surg. 2009;88:1112–7.

    Article  PubMed  Google Scholar 

  40. Suzumura Y, Terada Y, Sonobe M, Nagasawa M, Shindo T, Kitano M. A case of unilateral diaphragmatic eventration treated by plication with thoracoscopic surgery. Chest. 1997;112(2):530–2.

    Article  CAS  PubMed  Google Scholar 

  41. Hwang Z, Shin JS, Cho YH, Sun K, Lee IS. A simple technique for the thoracoscopic plication of the diaphragm. Chest. 2003;124(1):376–8.

    Article  PubMed  Google Scholar 

  42. Moon SW, Wang YP, Kim YW, Shim SB, Jin W. Thoracoscopic plication of diaphragmatic eventration using endostaplers. Ann Thorac Surg. 2000;70(1):299–300.

    Article  CAS  PubMed  Google Scholar 

  43. Kizilcan F, Tanyel FC, Hiçsönmez A, Büyükpamukçu N. The long-term results of diaphragmatic plication. J Pediatr Surg. 1993;28(1):42–4.

    Article  CAS  PubMed  Google Scholar 

  44. Huttl 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(3):547–51.

    Article  CAS  PubMed  Google Scholar 

  45. Groth SS, Andrade RS. Diaphragmatic eventration. Thorac Surg Clin. 2009;19(4):511–9.

    Article  PubMed  Google Scholar 

  46. Groth SS, Andrade RS. Diaphragm plication for eventration or paralysis: a review of the literature. Ann Thorac Surg. 2010;89(6):S2146–50.

    Article  PubMed  Google Scholar 

  47. Groth SS, Rueth NM, Kast T, D’Cunha J, Kelly RF, Maddaus MA, Andrade RS. Laparoscopic diaphragmatic plication for diaphragmatic paralysis and eventration: an objective evaluation of short term and midterm results. J Thorac Cardiovasc Surg. 2010;139(6):1452–6.

    Article  PubMed  Google Scholar 

  48. Phadnis J, Pilling JE, Evans TW, Goldstraw P. Abdominal compartment syndrome: a rare complication of plication of the diaphragm. Ann Thorac Surg. 2006;82(1):334–6.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Section of Thoracic and Foregut Surgery, Division of Cardiothoracic Surgery, University of Minnesota, 420 Delaware St. SE, MMC 207, Minneapolis, MN, 55455, USA

    Eitan Podgaetz MD & Rafael S. Andrade MD

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  1. Eitan Podgaetz MD
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  2. Rafael S. Andrade MD
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Correspondence to Rafael S. Andrade MD .

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  1. Surgery, University of Chicago, Chicago, Illinois, USA

    Mark K. Ferguson

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Podgaetz, E., Andrade, R.S. (2014). Diaphragmatic Plication for Eventration. In: Ferguson, M. (eds) Difficult Decisions in Thoracic Surgery. Difficult Decisions in Surgery: An Evidence-Based Approach, vol 1. Springer, London. https://doi.org/10.1007/978-1-4471-6404-3_40

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  • DOI: https://doi.org/10.1007/978-1-4471-6404-3_40

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  • Online ISBN: 978-1-4471-6404-3

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