Journal article
Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients
Journal of reconstructive microsurgery, v 33(1), pp 63-69
01 Jan 2017
PMID: 27665114
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis.
Methods A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome.
Results Overall, 134 males and 46 females with an average age of 56 years (range: 1079 years) were treated. Mean baseline percent predicted values for forced expiratory volume in 1 second, forced vital capacity, vital capacity, and total lung capacity, were 61, 63, 67, and 75%, respectively. The corresponding percent improvements in percent predicted values were: 11, 6, 9, and 13% (p <= 0.01; <= 0.01; <= 0.05; <= 0.01). Mean preoperative SF-36 physical functioning survey scores were 39%, and an improvement to 65% was demonstrated following surgery (p <= 0.0001). Nerve conduction latency, improved by an average 23% (p <= 0.005), and there was a corresponding 125% increase in diaphragm motor amplitude (p <= 0.0001). A total of 89% of patients reported an overall improvement in breathing function.
Conclusion Long-term assessment of phrenic nerve reconstruction for diaphragmatic paralysis indicates functional correction and symptomatic relief.
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Details
- Title
- Long-Term Follow-Up after Phrenic Nerve Reconstruction for Diaphragmatic Paralysis: A Review of 180 Patients
- Creators
- Matthew R. Kaufman - Jersey Shore University Medical CenterAndrew I. Elkwood - Jersey Shore University Medical CenterDavid Brown - John F. Kennedy Medical CenterJohn Cece - Jersey Shore University Medical CenterCatarina Martins - College Station Medical CenterThomas Bauer - Jersey Shore University Medical CenterJason Weissler - Johnson UniversityKameron Rezzadeh - Olive View-UCLA Medical CenterReza Jarrahy - Olive View-UCLA Medical Center
- Publication Details
- Journal of reconstructive microsurgery, v 33(1), pp 63-69
- Publisher
- Thieme Medical Publishers
- Number of pages
- 7
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Surgery
- Web of Science ID
- WOS:000391907800010
- Scopus ID
- 2-s2.0-85010409935
- Other Identifier
- 991021930434004721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Surgery