Korean J Thorac Cardiovasc Surg.  2015 Oct;48(5):307-310. 10.5090/kjtcs.2015.48.5.307.

Open Transthoracic Plication of the Diaphragm for Unilateral Diaphragmatic Eventration in Infants and Children

• Alshorbagy A
• Mubarak Y

• KMID: 2382279
• DOI: http://doi.org/10.5090/kjtcs.2015.48.5.307

Abstract

BACKGROUND
To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood.
METHODS
This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets.
RESULTS
The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired). Reported symptoms included respiratory distress (91.7%), wheezing (75%), cough (66.7%), and recurrent pneumonia (50%). Preoperative mechanical ventilatory support was required in 41.7% of the patients. The mean length of hospital stay was 6.3+/-2.5 days. The mean follow-up period was 24.3+/-14.5 months. Preoperative symptoms were immediately relieved after surgery in 83.3% of patients and persisted in 16.7% of patients one year after surgery. All patients survived to the end of the two-year follow-up and none had recurrence of DE.
CONCLUSION
Early diagnosis and surgical plication of the diaphragm for symptomatic congenital or acquired diaphragmatic eventration offers a good clinical outcome with no recurrence.

Keyword

Diaphragm; Eventration; Plication; Thoracotomy

MeSH Terms

Child*
Cough
Diaphragm*
Diaphragmatic Eventration*
Early Diagnosis
Follow-Up Studies
Humans
Infant*
Length of Stay
Pneumonia
Polypropylenes
Polytetrafluoroethylene
Recurrence
Respiratory Sounds
Thoracotomy
Polypropylenes
Polytetrafluoroethylene