ArticleTranslational lung cancer research2020
Significant diaphragm elevation suggestive of phrenic nerve injury after thoracoscopic lobectomy for lung cancer: an underestimated problem.
Article in Translational lung cancer research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 12 citations in OpenAlex.
- Effects of rhomboid intercostal and sub-serratus plane block on perioperative analgesic efficacy and diaphragm excursion in video-assisted thoracic surgery: a prospective, randomized controlled trial.BMC anesthesiology · 2025Trial
- Is phrenic nerve-sparing worthwhile for phrenic-involved thymic epithelial tumors? A retrospective cohort study.JTCVS open · 2026Article
- Risk factors postoperative diaphragmatic dysfunction in video-assisted thoracic surgery patients: a dynamic digital radiography study.Journal of thoracic disease · 2026Article
- Impact of Phrenic Nerve Repair Using Intercostal Nerve Graft on Diaphragm Function after Thoracic Tumour Resection.Interdisciplinary cardiovascular and thoracic surgery · 2026Article
- Case Report: Early diaphragmatic plication for combined phrenic and recurrent laryngeal nerve injury after VATS thymectomy.Frontiers in medicine · 2026Article
- Diaphragm dysfunction: how to diagnose and how to treat?Breathe (Sheffield, England) · 2025Review
- Impact of Pulmonary Ligament Resection in Upper Lobectomies: A Multicenter Matched Cohort Study.Journal of clinical medicine · 2024Article
- Comparison of Early Postoperative Diaphragm Muscle Function after Lobectomy via VATS and Open Thoracotomy: A Sonographic Study.Life (Basel, Switzerland) · 2024Article
- Perioperative Diaphragm Dysfunction.Journal of clinical medicine · 2024Review
- Pulmonary function changes after thoracoscopic lobectomy versus intentional thoracoscopic segmentectomy for early-stage non-small cell lung cancer.Translational lung cancer research · 2021Article
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8 authors at 1 institution in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPhrenic nerve injury (PNI) during lung cancer surgery, without apparent nerve section or damage, is still not well-studied. The aim of our study is to find an easy and objective way to evaluate a significant diaphragm elevation (SDE) suggestive of inadvertent PNI and its incidence and impact on lung cancer patients undergone video-assisted thoracoscopic surgery (VATS) lobectomy.
methodsExtent of diaphragm elevation was first examined on chest X-ray in a cohort of patients with invasive thymoma in whom phrenic nerve was intentionally transected. The result was then used as the criterion to diagnose a SDE suggestive of PNI in another cohort of VATS lobectomy patients. Fluoroscopy test was used to validate the results. Spirometry test was repeated to evaluate pulmonary function loss after surgery.
resultsDiaphragm elevation was 24.24%±6.2% in 22 invasive thymoma-patients, with 30% elevation adopted as the criterion to diagnose SDE suggestive of PNI. In 753 VATS lobectomy patients, 56 (7.4%) were diagnosed of SDE. On Fluoroscopy test, diaphragm movement was significantly less in patients with diaphragm elevation >30% than those without (5.0
conclusionsPatients with more than 30% diaphragm elevation after VATS lobectomy is highly likely to have PNI and should undergo fluoroscopic validation. Inadvertent PNI during VATS lobectomy is an underestimated phenomenon and is associated with significantly greater loss of pulmonary function.
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