How Should Surgical Technique Be Chosen For Diaphragmatic Eventrations?

Aim: Diaphragmatic eventrations and paralysis in adulthood are among the rare conditions with unknown etiology. We evaluated 10 patients who were operated on because of diaphragmatic eventrations and dysfunctions between 2007 and 2010 in terms of clinical features and surgical options.Material and Method: Chest X-ray films, chest computed tomography and fluoroscopy, preoprerative evaluation of patients was used. Respiratory function tests were done for all patients only in preoperative period. Patients were approached with left posterolateral thoracotomy incision. One patient underwent polytetrafluoroethylene grafting, three patients underwent central tendon plication and six patients were operated by overlapping diaphragmatic parts. Results: Five patients were male and five patients were female with mean age of 39,5 years (range 13-68). Patients did not have a history of chronic diseases and findings of trauma or previous infections. Diaphragm was seen to get down at least two ribs on chest x-rays obtained postoperatively. Mean duration of hospital stay was 8,5 days (5-15 days). There was not a significant difference between patients in terms of duration of hospital stay, time to regression of symptoms despite different surgical methods. Discussion: Good prognosis, absence of permanent problems and significant clinical improvement of exercise capacity led us to recommend surgery for diaphragmatic eventrations and dysfunctions.