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Yoshitaka Fujii
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Ann Thorac Surg 1994;58:1755-1757
© 1994 The Society of Thoracic Surgeons

Articles

Plication of paralyzed hemidiaphragm after right sleeve pneumonectomy

Shin-ichi Takeda, MD*, Kazuya Nakahara, MD, Yoshitaka Fujii, MD, Masato Minami, MD, Hikaru Matsuda, MD

First Department of Surgery, Osaka University Medical School, Osaka, Japan

Accepted for publication June 10, 1994.

* Address reprint requests to Dr Takeda, Pulmonary Research Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd. Dallas, TX 75235-9034.

Right diaphragmatic plication was performed in a 62-year-old man who underwent right sleeve pneumonectomy and then required prolonged mechanical ventilation owing to right diaphragmatic paralysis. The plication was very effective in allowing him to be weaned from the ventilator. The transdiaphragmatic pressure, the ratio of gastric to esophageal pressure swing, and the work of breathing per liter of ventilation improved remarkably after plication. Our experience indicates the beneficial effect of such a plication on contralateral lung function from the standpoint of clinical and respiratory mechanics.




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