The Effect of Diaphragmatic Plication on Pulmonary Function Test, Dyspnea Score and Arterial Blood Gases: Analysis 11 Patients With Diaphragmatic Elevation

Abstract

Aim Diaphragmatic evantration or paralysis in adults is associated with respiratory distress. In this study, we aimed to compare preoperative and postoperative pulmonary function tests, arterial blood gas analyses and dyspnea scores of the cases in whom plication had been performed for diaphragmatic elevation. Material and Methods Between January 2004 and March 2010 eleven adult patients who had undergone diaphragmatic plication due to diaphragmatic paralysis and eventration were analyzed. There were 7 (63.63%) men and 4 (36.37%) women aged 28-65 (mean 38 +/- 2.9). Diaphragmatic plication was performed. Pulmonary function test, dyspnea scores, and arterial blood gases in the preoperative and postoperative period were studied. Results Dyspnea was present in all of the cases and a decrease in both FVC, FEV1, FEV1/FVC values of pulmonary function test and partial pressure of oxygen in the arterial blood were observed. In chest x-ray and thorax computed tomography, it was detected that right or left diaphragm was elevated. Diaphragmatic paralysis was detected by fluoroscopy in 6 patients. Transthoracally, diaphragmatic plication was performed to the cases. There were no postoperative complications or deaths. In postoperative six and twelve months, significant improvements in the symptoms, the values of pulmonary function tests, partial pressure of oxygen in the arterial blood and dyspnea scores of the patients were observed. Conclusions Diaphragmatic plication is a safe and effective procedure for adult patients with dyspnea due to unilateral diaphragmatic elevation. Lung expansion is easily achieved by performing diaphragm plication.