Surgical Outcomes of Pneumatic Compression Using Carbon Dioxide Gas in Thoracoscopic Diaphragmatic Plication.
10.5090/kjtcs.2016.49.6.456
- Author:
Hyo Yeong AHN
1
;
Yeong Dae KIM
;
Hoseok I
;
Jeong Su CHO
;
Jonggeun LEE
;
Joohyung SON
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Pusan National University Hospital, Medical Research Institution, Korea. domini@pnu.edu
- Publication Type:Original Article
- Keywords:
Diaphragm;
Thoracoscopy;
Video-assisted thoracic surgery;
Methods
- MeSH:
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
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2016;49(6):456-460
- CountryRepublic of Korea
- Language:English
-
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 CO₂ 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 CO₂ gas and the group not using CO₂ 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 CO₂) and 15.6±0.89 (without CO₂) (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 CO₂ insufflation could be an effective, safe option to flatten the diaphragm.
