@article{SHC3829,
author = {Davide Patrini and Nikolaos Panagiotopoulos and Benedetta Bedetti and David Lawrence and Marco Scarci},
title = {Diaphragmatic plication for eventration or paralysis},
journal = {Shanghai Chest},
volume = {1},
number = {4},
year = {2017},
keywords = {},
abstract = {Diaphragmatic eventration are congenital developmental defects affecting the muscular portion of the diaphragm, while the normal attachment to sternum ribs and dorsolumbar spine are maintained. Clinically diaphragm eventration is impossible to differentiate from acquired paralysis. In contrast to true diaphragmatic eventration, diaphragm paralysis is a more common acquired condition that can result from a number of abnormalities that affect the neuromuscular axis between the cervical spinal cord and the diaphragm. In most cases, patients with eventration or paralysis are asymptomatic and diagnosis is made as an incidental finding on a chest radiograph or as a diagnosis of exclusion in patient with dyspnoea. It is important to determine the start of the symptoms: generally patients with paralysis can recall the moment of the onset of symptoms or when the dyspnoea started or worsened while patients with eventration may not be able to determine a specific starting point. The only goal of diaphragmatic plication is to manage dyspnea. Therefore surgery is warranted exclusively for symptomatic patients. There are two main techniques to manage diaphragmatic elevation due to eventration or paralysis in open surgery through a thoracotomy access: central imbrication technique and radial plication technique. Diaphragmatic plication should be only performed on symptomatic patients with evidence of elevated diaphragm not caused by any other pathologic process other besides paralysis and eventration. The choice of plication approach is up to the surgeon’s expertise, training and preference. Improvement in dyspnoea is the most important measure of clinical success.},
issn = {2521-3768}, url = {https://shc.amegroups.org/article/view/3829}
}