Transthoracic radial plication technique for an adult patient with diaphragmatic eventration

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  • Tsukioka Takuma
    Department of General Thoracic Surgery, Osaka City General Hospital
  • Takahama Makoto
    Department of General Thoracic Surgery, Osaka City General Hospital
  • Nakajima Ryu
    Department of General Thoracic Surgery, Osaka City General Hospital
  • Kimura Michitaka
    Department of General Thoracic Surgery, Osaka City General Hospital
  • Inoue Hidetoshi
    Department of General Thoracic Surgery, Osaka City General Hospital
  • Yamamoto Ryoji
    Department of General Thoracic Surgery, Osaka City General Hospital

Bibliographic Information

Other Title
  • 成人横隔膜弛緩症に対する腱中心を温存した縫縮術（Transthoracic radial plication technique）

Description

<p>A 79-year-old female with respiratory failure was admitted to our institute. A chest radiograph showed eventration and paradoxical movement of the right diaphragm. Paradoxical respiration due to diaphragmatic eventration was diagnosed as the cause of respiratory failure. We selected a transthoracic radial plication technique to treat the diaphragmatic eventration. The transthoracic radial plication technique is a method of diaphragmatic plication with central tendon preservation. This technique is considered to reduce the risk of recurrence. Two skin incisions were made at the seventh and tenth inter-costal spaces. The bony thorax was exposed through the anterior serratus and latissimus dorsi muscle. The flaccid muscle of the ventral to lateral diaphragm was plicated and sutured to the eighth or ninth rib using an incision at the seventh inter-costal space. The flaccid muscle of the dorsal diaphragm was sutured to the tenth rib using an incision at the tenth inter-costal space. After plication of the diaphragm, the central tendon became taut, and paradoxical movement of the right diaphragm disappeared. The symptom was resolved after surgery. She was discharged to home 54 days after treatment, and is now leading a normal life at 18 months after treatment.</p>

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