P-234 * LONG-TERM RESULTS OF DIFFERENT SURGICAL CORRECTION TECHNIQUES IN DIAPHRAGMATIC EVENTRATION

Abstract

Objectives: Diaphragmatic eventration is defined by the long lasting or permanent elevation of the diaphragm without defects. There is no definite data about the benefit of different surgical technical corrections of the diaphragmatic location in adults. The aim of the study is to verify the benefit of different surgical correction techniques. Methods: Between January 2008 and November 2011, 26 consecutive adult patients with diaphragmatic elevation who underwent thoracotomy were retrospectively analyzed. Correction of the diaphragm was achieved either by accordion plication (n = 10) or by double-breasted plication (n = 16) through thoracotomy. Operative outcomes with clinical (Medical Research Council-MRC Dyspnoea score), radiological and functional improvement trends were compared between the groups after 12 and 24 months. Results: The mean follow-up was 18.7 ± 5.2 months (range 12-32). Most of the patients (77%) were operated for left-sided diaphragmatic eventration. The mean MRC dyspnoea score was 3.0. The mean elevation of the diaphragm was calculated as 5.7 ± 2.5 (3-11) cm. There was no statistically significant difference between both groups in age, gender, aetiology, preoperative spirometric values, degree of diaphragmatic elevation and time to surgery. However, in the double-breasted plication group drainage was statistically increased. Although the corrected diaphragm was statistically well preserved in the double-breasted plication group, this re-positioned diaphragm showed no effect on the value of spirometry and MRC score. No complication was noted specifically related to techniques. Conclusions: The results of the study show that radiological prospect of corrected diaphragm is well preserved with double-breasted plication, but respiratory function was not affected by the technique. Disclosure: No significant relationships.