Publication
Diaphragmmatic eventration: long-term follow-up and results of open-chest plicature
dc.contributor.author | Calvinho, P | |
dc.contributor.author | Bastos, C | |
dc.contributor.author | Bernardo, JE | |
dc.contributor.author | Eugénio, L | |
dc.contributor.author | Antunes, MJ | |
dc.date.accessioned | 2009-08-21T15:52:21Z | |
dc.date.available | 2009-08-21T15:52:21Z | |
dc.date.issued | 2009 | |
dc.description.abstract | Objective: Diaphragmmatic eventration is a relatively uncommon entity with a simple surgical correction technique - plication of the diaphragm. This study aims to assess the clinical and ventilatory impact of this technique. Materials: From April 1988 to February 2007, we operated on 20 patients (12 men) with diaphragmmatic eventration using the postero-lateral approach and correction by radial plication. The mean age of the patients studied was 56.3+/-15.6 years (range: 13-74 years). A traumatic cause was identified in 13 patients; one patient had a congenital cause and the remainder were of idiopathic origin. Chronic obstructive pulmonary disease and arterial hypertension were present in one-half of the study group, while diabetes mellitus was present in three patients. Dyspnoea was the most common complaint in 75% of the patients, and thoracic pain was present in 25%. The mean forced expiratory volume in 1s (FEV(1)) and vital capacity (VC) were 66.2+/-15.3% and 70.4+/-16% of the predicted values, respectively. Results: There was no operative mortality. Apart from a patient with moderate/severe pain and another who had pneumonia, there were no other important perioperative complications. Average drainage time was 3.3+/-1.6 days (range: 2-7 days). Hospitalisation time was 6.2+/-1.6 days (5-10 days). Follow-up was complete, for a mean of 59.6+/-55.1 months (4-206 months). There were three late deaths (one sudden, one stroke and one trauma). Eight of the 17 survivors (47%) are asymptomatic. According to the MRC/ATS grading system, the dyspnoea score was 2.06+/-0.97 preoperatively and 1.06+/-1.14 postoperatively (p=0.007). At follow-up, the FEV(1) was 76.1+/-20.1% and the VC was 78.4+/-17.3% (p>0.1). Two patients had chronic pain. Conclusion: Plication of the diaphragm is a safe and efficient procedure. Most patients experienced significant clinical improvement with enhancement of the FEV(1) and VC. Chronic surgical pain still remains a potential problem with the classical approach. | pt |
dc.identifier.citation | Eur J Cardiothorac Surg. 2009 Jul 23. | pt |
dc.identifier.uri | http://hdl.handle.net/10400.4/556 | |
dc.language.iso | eng | pt |
dc.publisher | Elsevier | pt |
dc.rights.uri | openAccess | en |
dc.subject | Doenças do Pulmão | pt |
dc.title | Diaphragmmatic eventration: long-term follow-up and results of open-chest plicature | pt |
dc.type | journal article | |
dspace.entity.type | Publication | |
rcaap.type | article | pt |