One-year quality of life and functional outcomes after robotic diaphragm plication for unilateral paralysis: A retrospective cohort analysis.
5 affiliations
- 1Department of Thoracic Surgery, Thoraxklinik, Heidelberg University Hospital, Heidelberg, Germany.
- 2Department of Pulmonology, Thoraxklinik at Heidelberg University Hospital, Heidelberg, Germany.
- 3Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
- 4Department of General, Abdominal, Transplant and Thoracic Surgery, University Hospital Frankfurt, Frankfurt am Main, Germany.
- 5Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany.
Abstract
Objectives
Unilateral diaphragm paralysis is a rare thoracic condition that can significantly impair respiratory function and quality of life. This retrospective study aims to evaluate the long-term functional and quality of life outcomes after robotic-assisted thoracoscopic diaphragm plication.Methods
Between 2019 and 2024, 82 patients with symptomatic unilateral diaphragm paralysis were included in a prospectively maintained database at a single institution. All patients underwent robotic-assisted thoracoscopic diaphragm plication. Quality of life was assessed using the Diaphragmatic Paralysis Questionnaire, and lung function was evaluated by body plethysmography and spirometry in the upright position. Postoperative complications were graded according to the Clavien-Dindo classification.Results
Quality of life improved significantly across all Diaphragmatic Paralysis Questionnaire domains at 3 months and 1 year (all P < .001). Overall improvements were maintained over time, although the respiratory domain showed a modest change between 3 months and 1 year (P = .013). Forced expiratory volume in 1 second and forced vital capacity increased significantly at both follow-up time points (all P < .001). No significant changes were observed in arterial blood gas parameters (partial pressure of oxygen and partial pressure of carbon dioxide). Diffusing capacity of the lung for carbon monoxide showed a modest improvement at 3 months (P = .009), which was not sustained at 1 year (P = .066). Within 90 days, 6 patients (7.3%) developed Clavien-Dindo grade III or greater complications, whereas pleural effusion (grade I) was the most frequent event.Conclusions
This retrospective analysis of a prospectively collected cohort suggests that robotic-assisted thoracoscopic diaphragm plication is associated with improved long-term quality of life and pulmonary function in patients with symptomatic unilateral diaphragm paralysis.
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BibTeX
@article{baum2026oneyear,
title = {{One-year quality of life and functional outcomes after robotic diaphragm plication for unilateral paralysis: A retrospective cohort analysis.}},
author = {Philip Baum and Raffaela Griffo and Matthias Grott and Henrike Deissner and Alessio Campisi and Mavi Schellenberg and Felix Herth and Jacopo Lenzi and Konstantin Uttinger and Hauke Winter and Martin E Eichhorn},
journal = {JTCVS open},
year = {2026},
month = aug,
doi = {10.1016/j.xjon.2026.102084},
url = {https://europepmc.org/article/MED/42948122},
note = {CC BY},
}
RIS
TY - JOUR
TI - One-year quality of life and functional outcomes after robotic diaphragm plication for unilateral paralysis: A retrospective cohort analysis.
AU - Philip Baum
AU - Raffaela Griffo
AU - Matthias Grott
AU - Henrike Deissner
AU - Alessio Campisi
AU - Mavi Schellenberg
AU - Felix Herth
AU - Jacopo Lenzi
AU - Konstantin Uttinger
AU - Hauke Winter
AU - Martin E Eichhorn
PY - 2026
DA - 2026/08/26
JO - JTCVS open
DO - 10.1016/j.xjon.2026.102084
UR - https://europepmc.org/article/MED/42948122
AB - Objectives Unilateral diaphragm paralysis is a rare thoracic condition that can significantly impair respiratory function and quality of life. This retrospective study aims to evaluate the long-term functional and quality of life outcomes after robotic-assisted thoracoscopic diaphragm plication.Methods Between 2019 and 2024, 82 patients with symptomatic unilateral diaphragm paralysis were included in a prospectively maintained database at a single institution. All patients underwent robotic-assisted thoracoscopic diaphragm plication. Quality of life was assessed using the Diaphragmatic Paralysis Questionnaire, and lung function was evaluated by body plethysmography and spirometry in the upright position. Postoperative complications were graded according to the Clavien-Dindo classification.Results Quality of life improved significantly across all Diaphragmatic Paralysis Questionnaire domains at 3 months and 1 year (all P < .001). Overall improvements were maintained over time, although the respiratory domain showed a modest change between 3 months and 1 year (P = .013). Forced expiratory volume in 1 second and forced vital capacity increased significantly at both follow-up time points (all P < .001). No significant changes were observed in arterial blood gas parameters (partial pressure of oxygen and partial pressure of carbon dioxide). Diffusing capacity of the lung for carbon monoxide showed a modest improvement at 3 months (P = .009), which was not sustained at 1 year (P = .066). Within 90 days, 6 patients (7.3%) developed Clavien-Dindo grade III or greater complications, whereas pleural effusion (grade I) was the most frequent event.Conclusions This retrospective analysis of a prospectively collected cohort suggests that robotic-assisted thoracoscopic diaphragm plication is associated with improved long-term quality of life and pulmonary function in patients with symptomatic unilateral diaphragm paralysis.
SN - 2666-2736
ER -