Diaphragmatic relaxation: Pathophysiological alterations and current possibilities of surgical repair

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COD: 131-136-1 Categorie: ,

Vassiliki Xenaki, Francesca Mitri, Gianni Sigismondi, Sonia Di Paolo, Nicola Picardi

Ann. Ital. Chir., 2006; 77: 131-136

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Diaphragmatic relaxation is a pathology not frequently observed because it is generally oligosymptomatic.
The development of modern technology has induced an important contribution to the diagnosis and treatment of the
disease which can find a possibility of restoration in surgery.
A 63-year-old patient with a light syndrome of respiration deficiency and an altered relaxed profile of the right cupola
was subjected to surgical treatment with the technique of diaphragmatic plicature without any adverse implication during
and after the operation. After a brief recovery, the patient was discharged and after 9 years he affirmed still absence of
dyspnoea from limited labor and absence of respiration problems. The selected surgical technique for the restoration of
the altered muscle is the diaphragmatic plicature without incision or excision of the altered part of the muscle. The preferable
access way today is that of laparotomy which is devoid of problems of thoracotomy and generally it permits quite
easily the restoration of all diaphragmatic defects.
Diaphragmatic plicature is a simple, effective and long-lasting intervention but we cannot determine the complete recovery
of the normal contractile function of the muscle. There is no morbidity and mortality directly related to this technique,
the latter incidentally associated with complications of general anesthesia.

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