The importance of phrenic nerve preservation and its effect on long-term postoperative lung function after pneumonectomy

Kocher, Gregor; Poulson, Jannie Lysgaard; Blichfeldt-Eckhardt, Morten Rune; Elle, Bo; Schmid, Ralph; Licht, Peter B (2015). The importance of phrenic nerve preservation and its effect on long-term postoperative lung function after pneumonectomy. European journal of cardio-thoracic surgery, 49(4), pp. 1059-1062. Oxford University Press 10.1093/ejcts/ezv334

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OBJECTIVES The importance of phrenic nerve preservation during pneumonectomy remains controversial. We previously demonstrated that preservation of the phrenic nerve in the immediate postoperative period preserved lung function by 3-5% but little is known about its long-term effects. We, therefore, decided to investigate the effect of temporary ipsilateral cervical phrenic nerve block on dynamic lung volumes in mid- to long-term pneumonectomy patients. METHODS We investigated 14 patients after a median of 9 years post pneumonectomy (range: 1-15 years). Lung function testing (spirometry) and fluoroscopic and/or sonographic assessment of diaphragmatic motion on the pneumonectomy side were performed before and after ultrasonographic-guided ipsilateral cervical phrenic nerve block by infiltration with lidocaine. RESULTS Ipsilateral phrenic nerve block was successfully achieved in 12 patients (86%). In the remaining 2 patients, diaphragmatic motion was already paradoxical before the nerve block. We found no significant difference on dynamic lung function values (FEV1 'before' 1.39 ± 0.44 vs FEV1 'after' 1.38 ± 0.40; P = 0.81). CONCLUSIONS Induction of a temporary diaphragmatic palsy did not significantly influence dynamic lung volumes in mid- to long-term pneumonectomy patients, suggesting that preservation of the phrenic nerve is of greater importance in the immediate postoperative period after pneumonectomy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Thoraxchirurgie
04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery

UniBE Contributor:

Kocher, Gregor and Schmid, Ralph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1010-7940

Publisher:

Oxford University Press

Language:

English

Submitter:

Thomas Michael Marti

Date Deposited:

04 Apr 2016 12:13

Last Modified:

18 Jan 2017 16:30

Publisher DOI:

10.1093/ejcts/ezv334

PubMed ID:

26405235

Uncontrolled Keywords:

Diaphragm; Lung cancer; Phrenic nerve; Pneumonectomy; Pulmonary function

BORIS DOI:

10.7892/boris.77740

URI:

https://boris.unibe.ch/id/eprint/77740

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