Reinnervation of the Diaphragm After Bilateral Phrenic Nerve Resection and Immediate Reconstruction Using a Contralateral Phrenic Nerve Autograft
Reinnervation of the Diaphragm After Bilateral Phrenic Nerve Resection and Immediate Reconstruction Using a Contralateral Phrenic Nerve Autograft
复制标题
双侧膈神经切除和使用对侧膈神经自体移植物立即重建后膈肌的神经再支配
DOI：
10.1097/sap.0000000000002543
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发表时间：
2020
影响因子：
1.5
通讯作者：
P. Persichetti
中科院分区：
文献类型：
--
作者：
B. Brunetti;M. Morelli Coppola;P. Crucitti;F. Spinelli;F. Stilo;F. Longo;L. Cortese;S. Tenna;P. Persichetti
文本中提供了补充的数字内容。摘要1例巨大的纵隔滑膜肉瘤患者接受了根治性手术，导致双侧膈神经损伤。由于肿瘤部位的原因，不能重建左侧的膈神经，因此为了防止患者对呼吸机的依赖，对侧膈神经的残端采用自体移植的方法进行重建。3个月后，患者右半横肌功能完全恢复，超声和X线片评估横隔膜偏移，患者脱离机械通气。当自体神经移植指征时，腓肠神经仍然是标准的标准，因为供区发病率低，取材容易；然而，在特殊情况下，例如在这个独特的病例中，选择原位移植可能会提供有希望的结果。
Supplemental digital content is available in the text. Abstract A patient affected by a voluminous synovial sarcoma of mediastinum received radical surgery, resulting in injury of both phrenic nerves. Because of the cancer location, reconstruction of the left phrenic nerve was not possible, so to prevent the patient's ventilator dependence, the right phrenic nerve was reconstructed via an autograft from the residual proximal stump of the contralateral one. In 3 months, the right hemidiaphragm function showed a full recovery, documented by ultrasonographic and radiographic assessment of diaphragmatic excursion, and the patient was weaned from mechanical ventilation. When a nerve autograft is indicated, the sural nerve still remains the criterion standard, because of the low morbidity of the donor site and ease of harvesting; however, in particular situations, such as in this unique case, the choice of an orthotopic graft may offer promising results.