title: Comparison of Mid-Term Clinical Outcomes of Different Surgical Approaches in Symptomatic Diaphragmatic Eventration.
abstract: OBJECTIVE
  There is no data comparing different surgical techniques for diaphragmatic re-positioning for hemi-diaphragmatic eventration in adults. Our aim was to verify the potential pros and cons of two major surgical techniques in symptomatic eventration patients.
  
  
  METHODS
  Patients undergoing thoracotomy for diaphragmatic elevation repair either by un-opened (accordion placation) or by opened (double-breasted placation) diaphragmatic technique between January 2007 and August 2013 were analyzed retrospectively, and compared in terms of operative outcomes on 12th and 24th months.
  
  
  RESULTS
  Forty-two patients underwent accordion (n = 23) or double-breasted (n = 19) plication. Postoperative drainage was significantly increased (215 ± 66 ml vs. 114 ± 48 ml; P = 0.0082) in double-breasted group. Although the corrected diaphragm was radiologically better preserved in this group, this divergence showed no additional effect on postoperative pulmonary functions or the dyspnea score on 12th or 24th months. No complication particularly related to both techniques or recurrence was noted during follow-up of 28 ± 12 months.
  
  
  CONCLUSIONS
  Radiological prospect of corrected diaphragm is better preserved with double-breasted plication, but the significant and permanent improvement of respiratory functions was similar. Since the clinical outcome is equivalent, incision of the diaphragm is not essential.
authors.affiliation: Department of Thoracic Surgery, Sureyyapasa Chest Diseases and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Evman
authors.forename: Cagatay
authors.initials: C
authors.lastname: Tezel
authors.forename: Mustafa
authors.initials: M
authors.lastname: Vayvada
authors.forename: Serda
authors.initials: S
authors.lastname: Kanbur
authors.forename: Senol
authors.initials: S
authors.lastname: Urek
authors.forename: Volkan
authors.initials: V
authors.lastname: Baysungur
authors.forename: Irfan
authors.initials: I
authors.lastname: Yalçınkaya
mesh_terms: D000328:Adult; D000368:Aged; D003964:Diaphragm / Q000002:abnormalities / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D003965:Diaphragmatic Eventration / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D020127:Recovery of Function; D012189:Retrospective Studies; D012307:Risk Factors; D013536:Suture Techniques / Q000009:adverse effects; D013908:Thoracotomy; D013997:Time Factors; D016896:Treatment Outcome; D014797:Vital Capacity; D055815:Young Adult