12.07.2015 Views

Boston - American Association for Thoracic Surgery

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AMERICAN ASSOCIATION FOR THORACIC SURGERY3:45 p.m. SIMULTANEOUS SCIENTIFIC SESSION –GENERAL THORACIC SURGERYRoom 312, Hynes Convention CenterModerators: Nasser K. AltorkiShaf Keshavjee44. Laparoscopic Diaphragm Plication: An Objective Evaluation ofShort-and Mid-Term ResultsShawn S. Groth, 1 Natasha M. Rueth, 1 Amy Klopp, 1 Teri Kast, 1 Jonathan D’Cunha, 1*Rosemary F. Kelly, 2* Michael A. Maddaus, 1* Rafael S. Andrade, 11. <strong>Surgery</strong>, University of Minnesota, Minneapolis, MN, USA;2. Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USAInvited Discussant: Sudish C. MurthyOBJECTIVE: To objectively assess laparoscopic diaphragm plication (LDP) <strong>for</strong>hemidiaphragm paralysis or eventration (HPE) using pulmonary function tests(PFTs) and a respiratory quality of life questionnaire.METHODS: We per<strong>for</strong>med an Institutional Review Board-approved prospectivecohort study of symptomatic patients with HPE who underwent LDP from April2005 through September 2008. Patients with primary neuromuscular disorderswere excluded from our analysis. We evaluated patients with pulmonary functionstests (PFT) and the St. George’s Respiratory Questionnaire (SGRQ) preoperativelyand 1 and 12 months postoperatively. The SGRQ is a standardized questionnairethat evaluates the health impairment from respiratory disease; we report the totalscore (range, 0 to 100; normal score, ≤ 6; highest score = maximum impairment). Achange of >4 points after an intervention is considered significant. Matched pairs ttests were utilized to evaluate the changes between preoperative and postoperativePFT results and SGRQ scores. A 2-sided significance level of 0.05 was used <strong>for</strong> allstatistical testing.TUESDAYAfternoonRESULTS: During the study period, 22 patients underwent LDP. We had 1 conversionto open. Two patients developed pleural effusions that required drainage;we found no other complications. Preoperative and 1-month postoperative PFTswere obtained from 20 patients; 11 of these patients also completed 12-month postoperativePFT. As compared with preoperative values, we noted a significantimprovement in the 1-month postoperative % predicted <strong>for</strong>ced vital capacity(FVC%), % predicted <strong>for</strong>ced expiratory volume in 1 second (FEV1%), and maximum<strong>for</strong>ced inspiratory flow (FIFMAX) (Table). The improvement in these PFT parameterspersisted at 12 months.* AATS Member177

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