A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report

Abstract Background Pulmonary carcinoma patients with low pulmonary function cannot be treated surgically because of the high risk of complications. Diaphragmatic eventration is a disease characterized by diaphragmatic paralysis and dyspnea. Here, we report a surgical case of multiple pulmonary carc...

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Main Authors: Yukiko Matsui, Shigetoshi Yoshida, Takekazu Iwata, Kazuhisa Tanaka, Takayoshi Yamamoto, Kai Nishii, Toshihiko Iizasa
Format: Article
Language:English
Published: Japan Surgical Society 2019-05-01
Series:Surgical Case Reports
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Online Access:http://link.springer.com/article/10.1186/s40792-019-0648-z
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author Yukiko Matsui
Shigetoshi Yoshida
Takekazu Iwata
Kazuhisa Tanaka
Takayoshi Yamamoto
Kai Nishii
Toshihiko Iizasa
author_facet Yukiko Matsui
Shigetoshi Yoshida
Takekazu Iwata
Kazuhisa Tanaka
Takayoshi Yamamoto
Kai Nishii
Toshihiko Iizasa
author_sort Yukiko Matsui
collection DOAJ
description Abstract Background Pulmonary carcinoma patients with low pulmonary function cannot be treated surgically because of the high risk of complications. Diaphragmatic eventration is a disease characterized by diaphragmatic paralysis and dyspnea. Here, we report a surgical case of multiple pulmonary carcinomas with contralateral diaphragmatic eventration. Case presentation The patient was a 75-year-old woman with multiple metachronous right lung carcinomas complicated by left diaphragmatic eventration. When she was 70 years old, a right upper lobectomy and right S6b wedge resection were performed for double lung carcinomas. Five years later, two new lung tumors in her right lower lobe and left diaphragmatic eventration were identified, but resection was thought to be impossible because of her low pulmonary function. We performed video-assisted thoracoscopic surgery (VATS) plication with carbon dioxide (CO2) insufflation for the left diaphragmatic eventration, and her pulmonary function improved. Subsequently, we performed a right S6 wedge resection and right S9 segmentectomy for the double lung tumors with no complications. The tumors were diagnosed as double primary carcinomas. Conclusions Our case presented with low pulmonary function and right multiple lung carcinomas with left diaphragmatic eventration. VATS plication for the left diaphragmatic eventration achieved improvement in her pulmonary function, and right pulmonary resection for the lung carcinomas was performed. VATS plication can expand the choice of treatments in such cases.
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spelling doaj-art-e5c96d17573e4422886c3b6dbe7211352025-08-20T03:19:07ZengJapan Surgical SocietySurgical Case Reports2198-77932019-05-01511510.1186/s40792-019-0648-zA strategy for pulmonary resection after contralateral diaphragm plication: a surgical case reportYukiko Matsui0Shigetoshi Yoshida1Takekazu Iwata2Kazuhisa Tanaka3Takayoshi Yamamoto4Kai Nishii5Toshihiko Iizasa6Department of Thoracic Surgery, Chiba Cancer CenterDepartment of Thoracic Surgery, Chiba Cancer CenterDepartment of Thoracic Surgery, Chiba Cancer CenterDepartment of Thoracic Surgery, Chiba Cancer CenterDepartment of General Thoracic Surgery, Graduate School of Medicine, Chiba UniversityDepartment of Thoracic Surgery, Chiba Cancer CenterDepartment of Thoracic Surgery, Chiba Cancer CenterAbstract Background Pulmonary carcinoma patients with low pulmonary function cannot be treated surgically because of the high risk of complications. Diaphragmatic eventration is a disease characterized by diaphragmatic paralysis and dyspnea. Here, we report a surgical case of multiple pulmonary carcinomas with contralateral diaphragmatic eventration. Case presentation The patient was a 75-year-old woman with multiple metachronous right lung carcinomas complicated by left diaphragmatic eventration. When she was 70 years old, a right upper lobectomy and right S6b wedge resection were performed for double lung carcinomas. Five years later, two new lung tumors in her right lower lobe and left diaphragmatic eventration were identified, but resection was thought to be impossible because of her low pulmonary function. We performed video-assisted thoracoscopic surgery (VATS) plication with carbon dioxide (CO2) insufflation for the left diaphragmatic eventration, and her pulmonary function improved. Subsequently, we performed a right S6 wedge resection and right S9 segmentectomy for the double lung tumors with no complications. The tumors were diagnosed as double primary carcinomas. Conclusions Our case presented with low pulmonary function and right multiple lung carcinomas with left diaphragmatic eventration. VATS plication for the left diaphragmatic eventration achieved improvement in her pulmonary function, and right pulmonary resection for the lung carcinomas was performed. VATS plication can expand the choice of treatments in such cases.http://link.springer.com/article/10.1186/s40792-019-0648-zVATS diaphragm plicationCO2 insufflationMultiple lung carcinomasPulmonary function
spellingShingle Yukiko Matsui
Shigetoshi Yoshida
Takekazu Iwata
Kazuhisa Tanaka
Takayoshi Yamamoto
Kai Nishii
Toshihiko Iizasa
A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
Surgical Case Reports
VATS diaphragm plication
CO2 insufflation
Multiple lung carcinomas
Pulmonary function
title A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
title_full A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
title_fullStr A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
title_full_unstemmed A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
title_short A strategy for pulmonary resection after contralateral diaphragm plication: a surgical case report
title_sort strategy for pulmonary resection after contralateral diaphragm plication a surgical case report
topic VATS diaphragm plication
CO2 insufflation
Multiple lung carcinomas
Pulmonary function
url http://link.springer.com/article/10.1186/s40792-019-0648-z
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