Video-assisted thoracoscopy for diaphragmatic plication: experimental study in a canine model.
BACKGROUND
Plication of a nonfunctional hemidiaphragm usually restores altered ventilatory mechanics. This study compared two techniques in performing diaphragmatic plication: video-assisted thoracoscopy (group A) and thoracotomy (group B).


METHODS
Twenty dogs with induced paralysis of the right hemidiaphragm were randomly assigned to one of the two groups. Evaluations were performed before and after plication of the respiratory frequency (f) and lung area (LA) of the affected side. Operative time, time to resumption of walking, ingestion of fluids and solid food, pain intensity, and postoperative complications were measured.


RESULTS
Group A had less pain after the surgery (P < 0.0001), earlier fluid ingestion (P < 0.05), and earlier resumption of walking (P < 0.019). Four weeks after the procedure, LA was similar in both groups, while a significant decrease in f was recorded in group A (P < 0.02). The remaining evaluated variables showed no differences.


CONCLUSIONS
Both approaches were effective. Pain recorded in the postoperative period was less and recovery was faster in group A. Complications and surgical times were similar. The video-assisted thoracoscopy is a safe and efficient option for performing diaphragmatic plication in dogs.
Gonzalez-Zamora
Jose F
JF
Laboratory of Experimental Surgery, Instituto Nacional de Pediatría, Mexico City, Mexico. govi0109@prodigy.net.mx
Perez-Guille
Beatriz
B
Soriano-Rosales
Rosa E
RE
Jimenez-Bravo-Luna
Miguel A
MA
Gutierrez-Castrellon
Pedro
P
Ridaura-Sanz
Cecilia
C
Alvarez
Fernando Villegas
FV
D000818:Animals; D003965:Diaphragmatic Eventration / Q000601:surgery*; D004285:Dogs; D010149:Postoperative Pain / Q000175:diagnosis; D011183:Postoperative Complications; D011897:Random Allocation; D012133:Respiratory Paralysis / Q000601:surgery*; D020775:Thoracic Surgery, Video-Assisted; D013906:Thoracoscopy / Q000379:methods*