Korean J Thorac Cardiovasc Surg.  2016 Dec;49(6):456-460. 10.5090/kjtcs.2016.49.6.456.

Surgical Outcomes of Pneumatic Compression Using Carbon Dioxide Gas in Thoracoscopic Diaphragmatic Plication

Affiliations
  • 1Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Medical Research Institution, Korea. domini@pnu.edu

Abstract

BACKGROUND
Surgical correction needs to be considered when diaphragm eventration leads to impaired ventilation and respiratory muscle fatigue. Plication to sufficiently tense the diaphragm by VATS is not as easy to achieve as plication by open surgery. We used pneumatic compression with carbon dioxide (CO2) gas in thoracoscopic diaphragmatic plication and evaluated feasibility and efficacy.
METHODS
Eleven patients underwent thoracoscopic diaphragmatic plication between January 2008 and December 2013 in Pusan National University Hospital. Medical records were retrospectively reviewed, and compared between the group using COâ‚‚ gas and group without using CO2 gas, for operative time, plication technique, duration of hospital stay, postoperative chest tube drainage, pulmonary spirometry, dyspnea score pre- and postoperation, and postoperative recurrence.
RESULTS
The improvement of forced expiratory volume at 1 second in the group using COâ‚‚ gas and the group not using COâ‚‚ gas was 22.46±11.27 and 21.08±5.39 (p=0.84). The improvement of forced vital capacity 3 months after surgery was 16.74±10.18 (with COâ‚‚) and 15.6±0.89 (without COâ‚‚) (p=0.03). During follow-up (17±17 months), there was no dehiscence in plication site and relapse. No complications or hospital mortalities occurred.
CONCLUSION
Thoracoscopic plication under single lung ventilation using COâ‚‚ insufflation could be an effective, safe option to flatten the diaphragm.

Keyword

Diaphragm; Thoracoscopy; Video-assisted thoracic surgery; Methods

MeSH Terms

Busan
Carbon Dioxide*
Carbon*
Chest Tubes
Diaphragm
Diaphragmatic Eventration
Drainage
Dyspnea
Fatigue
Follow-Up Studies
Forced Expiratory Volume
Hospital Mortality
Humans
Insufflation
Length of Stay
Medical Records
Methods
One-Lung Ventilation
Operative Time
Recurrence
Respiratory Muscles
Retrospective Studies
Spirometry
Thoracic Surgery, Video-Assisted
Thoracoscopy
Transcutaneous Electric Nerve Stimulation
Ventilation
Vital Capacity
Carbon
Carbon Dioxide
Full Text Links
  • KJTCS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr