J.Jpn. Surg. Soc.. 117(4): 308-315, 2016

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Feature topic

APPLICATION OF RECONSTRUCTIVE SURGICAL TECHNIQUES FOR THE PERIPHERAL NERVE TO INJURED PHRENIC NERVE TO RESTORE THE PARALYZED DIAPHRAGM

Phrenic nerve injury often causes diaphragmatic dysfunction. Damage to the phrenic nerve may be caused by iatrogenic injury such as transection or crush during thoracic or neck surgery to treat bronchogenic, mediastinal, or neck tumors. Plication of the diaphragm is a procedure in which the flaccid hemidiaphragm is tautened by oversuturing it. Although it has been offered to patients with unilateral diaphragmatic paralysis who have severe dyspnea and other symptoms, the essential treatment should be restoration of the function to the paralyzed diaphragm. Established reconstructive techniques for peripheral nerves are indicated to treat some phrenic nerve injury cases. Muscle contraction and diaphragmatic function following nerve reconduction is recovered in many clinical cases, and favorable experimental results were seen in animal models. Reconstructive nerve procedures such as repair, graft, or transfer may be indicated in more cases of phrenic nerve injury to improve prognostic outcomes of surgery to treat locally advanced malignancies.

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