Abstract:
OBJECTIVE:Eventration of the diaphragm (ED) is defined as the abnormal elevation of the diaphragm. Although asymptomatic ED may be amenable to conservative treatment, symptomatic ED in children, either congenital or acquired, may require surgical treatment. This study evaluated the results of diaphragmatic plication in children with unilateral ED. METHODS:Fifteen patients who had undergone diaphragmatic plication for ED between 1997 and 2003 were evaluated retrospectively. The diagnosis of ED was established by routine chest radiographs and fluoroscopy. Patients who failed to respond to nonoperative treatment were referred for surgery. Nine patients underwent diaphragmatic fluoroscopy 1-5 years following plication to assess function. RESULTS:Indications for diaphragmatic plication were respiratory symptoms such as tachypnoea, dyspnoea, recurrent pneumonia and failure to thrive. In 14 patients, the position of the diaphragm was normal after plication, but the diaphragm was elevated without symptoms in one patient during postoperative follow-up. The motion of the diaphragm was investigated in nine patients. Fluoroscopic studies showed that the operated hemidiaphragm was immobile and there was no paradoxical motion. No return of symptoms was found during follow-up. CONCLUSION:ED is the abnormal elevation of the diaphragm as a result of paralysis or aplasia of the muscular fibres. The abnormally elevated diaphragm may compress the ipsilateral lung, and with respiratory effort the mediastinum may shift towards the normal side. Therefore, diaphragmatic plication is performed to restore normal pulmonary parenchymal volume by replacing the diaphragm in its normal location. After plication, there was immediate remission of symptoms in most patients and decreasing symptoms were observed for a year in others. During follow-up, the location of the diaphragm was normal and no paradoxical movement was observed. Relapse of symptoms was not noted in patients with immobile diaphragms.
journal_name
Asian J Surgjournal_title
Asian journal of surgeryauthors
Tiryaki T,Livanelioğlu Z,Atayurt Hdoi
10.1016/S1015-9584(09)60285-2keywords:
subject
Has Abstractpub_date
2006-01-01 00:00:00pages
8-10issue
1eissn
1015-9584issn
0219-3108pii
S1015-9584(09)60285-2journal_volume
29pub_type
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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更新日期:2002-07-01 00:00:00
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journal_title:Asian journal of surgery
pub_type: 杂志文章,评审
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章
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journal_title:Asian journal of surgery
pub_type: 杂志文章
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journal_title:Asian journal of surgery
pub_type: 杂志文章
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更新日期:2010-10-01 00:00:00
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journal_title:Asian journal of surgery
pub_type: 杂志文章
doi:
更新日期:2005-04-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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pub_type: 杂志文章,评审
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更新日期:2008-04-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:Asian journal of surgery
pub_type: 杂志文章
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更新日期:2011-01-01 00:00:00
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journal_title:Asian journal of surgery
pub_type: 杂志文章
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更新日期:2017-04-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:2017-07-01 00:00:00