{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T22:00:42Z","timestamp":1780351242772,"version":"3.54.1"},"reference-count":15,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dam Med J"],"abstract":"<jats:p>INTRODUCTION. Flattening of a paralytic hemidiaphragm by plication may alleviate respiratory symptoms. For decades, the operation was performed through a thoracotomy that caused substantial morbidity, but now minimally invasive video-assisted thoracoscopic approaches are available. We technically modified the procedure using CO2 insufflation and pledged sutures and aimed to investigate changes in lung function and satisfaction rates in adult patients with hemidiaphragmatic paralysis.\n\nMETHODS. We retrospectively searched the electronic patient record system for pre- and post-operative pulmonary function tests and satisfaction rates at clinical follow-up.\n\nRESULTS. During a three-year period (2021-2023), 15 patients were operated on at a median age of 58 years. Pulmonary function tests improved significantly after diaphragmatic plication (p &lt; 0.01), and nine of 12 patients with available data reported symptomatic improvement (p = 0.02). The median length of hospital stay was one day.\n\nCONCLUSIONS. Minimally invasive diaphragmatic plication improves pulmonary function and respiratory symptoms in patients with hemidiaphragmatic paralysis.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Retrospective follow-up.<\/jats:p>","DOI":"10.61409\/a05250416","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T12:23:11Z","timestamp":1768220591000},"page":"1-6","source":"Crossref","is-referenced-by-count":1,"title":["Video-assisted thoracoscopic plication in symptomatic adults with paralytic hemidiaphragm"],"prefix":"10.61409","author":[{"given":"Camilla M\u00f8ller","family":"Larsen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Finn","family":"Dittberner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Licht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Stenger","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"40208","published-online":{"date-parts":[[2025,12]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Dub\u00e9 BP, Dres M. Diaphragm dysfunction: diagnostic approaches and management strategies. J Clin Med. 2016;5(12):113. https:\/\/doi.org\/10.3390\/jcm5120113","DOI":"10.3390\/jcm5120113"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Groth SS, Rueth NM, Kast T, et al. Laparoscopic diaphragmatic plication for diaphragmatic paralysis and eventration: an objective evaluation of short-term and midterm results. J Thorac Cardiovasc Surg. 2010;139(6):1452-1456. https:\/\/doi.org\/10.1016\/j.jtcvs.2009.10.020","DOI":"10.1016\/j.jtcvs.2009.10.020"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Gritsiuta AI, Gordon M, Bakhos CT, et al. Minimally invasive diaphragm plication for acquired unilateral diaphragm paralysis: a systematic review. Innovations (Phila). 2022;17(3):180-190. https:\/\/doi.org\/10.1177\/15569845221097761","DOI":"10.1177\/15569845221097761"},{"key":"ref3","doi-asserted-by":"publisher","unstructured":"Yongue C, Geraci TC, Chang SH. Management of diaphragm paralysis and eventration. Thorac Surg Clin. 2024;34(2):179-187. https:\/\/doi.org\/10.1016\/j.thorsurg.2024.01.006","DOI":"10.1016\/j.thorsurg.2024.01.006"},{"key":"ref4","doi-asserted-by":"publisher","unstructured":"Celik S, Celik M, Aydemir B, et al. Long-term results of diaphragmatic plication in adults with unilateral diaphragm paralysis. J Cardiothorac Surg. 2010;5:111. https:\/\/doi.org\/10.1186\/1749-8090-5-111","DOI":"10.1186\/1749-8090-5-111"},{"key":"ref5","doi-asserted-by":"publisher","unstructured":"Freeman RK, Wozniak TC, Fitzgerald EB. Functional and physiologic results of video-assisted thoracoscopic diaphragm plication in adult patients with unilateral diaphragm paralysis. Ann Thorac Surg. 2006;81(5):1853-1857. https:\/\/doi.org\/10.1016\/j.athoracsur.2005.11.068","DOI":"10.1016\/j.athoracsur.2005.11.068"},{"key":"ref6","doi-asserted-by":"publisher","unstructured":"Graham DR, Kaplan D, Evans CC, et al. Diaphragmatic plication for unilateral diaphragmatic paralysis: a 10-year experience. Ann Thorac Surg. 1990;49(2):248-251. https:\/\/doi.org\/10.1016\/0003-4975(90)90146-W","DOI":"10.1016\/0003-4975(90)90146-W"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Gilbert A, Wei B. Diaphragmatic plication: current evidence and techniques in the management of the elevated hemidiaphragm. Video-assist Thorac Surg. 2023;8:16. https:\/\/doi.org\/10.21037\/vats-22-38","DOI":"10.21037\/vats-22-38"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Beshay M, Bary MA, K\u00f6sek V, et al. Minimally-invasive diaphragmatic plication in patients with unilateral diaphragmatic paralysis. J Clin Med. 2023;12(16):5301. https:\/\/doi.org\/10.3390\/jcm12165301","DOI":"10.3390\/jcm12165301"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Valenti J, Tan K, Rubino K, et al. Quality-of-life impact of diaphragm plication in patients with diaphragmatic paralysis: a retrospective study. Ann Thorac Med. 2024;19(1):105-111. https:\/\/doi.org\/10.4103\/atm.atm_158_23","DOI":"10.4103\/atm.atm_158_23"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Freeman RK, Van Woerkom J, Vyverberg A, Ascioti AJ. Long-term follow-up of the functional and physiologic results of diaphragm plication in adults with unilateral diaphragm paralysis. Ann Thorac Surg. 2009;88(4):1112-1117. https:\/\/doi.org\/10.1016\/j.athoracsur.2009.05.027","DOI":"10.1016\/j.athoracsur.2009.05.027"},{"key":"ref11","doi-asserted-by":"publisher","unstructured":"Gazala S, Hunt I, B\u00e9dard ELR. Diaphragmatic plication offers functional improvement in dyspnoea and better pulmonary function with low morbidity. Interact Cardiovasc Thorac Surg. 2012;15(3):505-508. https:\/\/doi.org\/10.1093\/icvts\/ivs238","DOI":"10.1093\/icvts\/ivs238"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Demos DS, Berry MF, Backhus LM, Shrager JB. Video-assisted thoracoscopic diaphragm plication using a running suture technique is durable and effective. J Thorac Cardiovasc Surg. 2017;153(5):1182-1188. https:\/\/doi.org\/10.1016\/j.jtcvs.2016.11.062","DOI":"10.1016\/j.jtcvs.2016.11.062"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Wu HH, Chen CH, Chang H, et al. A preliminary report on the feasibility of single-port thoracoscopic surgery for diaphragm plication in the treatment of diaphragm eventration. J Cardiothorac Surg. 2013;8:224. https:\/\/doi.org\/10.1186\/1749-8090-8-224","DOI":"10.1186\/1749-8090-8-224"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Deng Y, Byth K, Paterson HS. Phrenic nerve injury associated with high free right internal mammary artery harvesting. Ann Thorac Surg. 2003;76(2):459-463. https:\/\/doi.org\/10.1016\/S0003-4975(03)00511-3","DOI":"10.1016\/S0003-4975(03)00511-3"}],"container-title":["Danish Medical Journal"],"original-title":[],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T14:04:16Z","timestamp":1769522656000},"score":1,"resource":{"primary":{"URL":"https:\/\/ugeskriftet.dk\/dmj\/A05250416"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":15,"URL":"https:\/\/doi.org\/10.61409\/a05250416","relation":{},"ISSN":["2245-1919"],"issn-type":[{"value":"2245-1919","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}