Reconstruction of resected unilateral phrenic nerve using autologous intercostal nerve during malignant mediastinal...

In some patients, complete resection of malignant tumors requires phrenic nerve resection; however, this can cause postoperative phrenic nerve paralysis, leading to reduced respiratory function and limited performance of daily activities. We encountered two patients in whom the phrenic nerve was resected during surgery for a malignant anterior mediastinal tumor and subsequently reconstructed using autologous intercostal nerves to preserve the diaphragm function. Although neither patient had preoperative phrenic nerve paralysis, the phrenic nerve required resection to totally remove the encasing tumor. The third and fifth intercostal nerves were harvested and used for reconstruction because the extent of phrenic nerve resection was too long for direct suturing. Postoperative chest radiographs confirmed the preserved diaphragm function during inspiration and expiration. In patients in whom long phrenic nerve sections are resected, the use of the intercostal nerve for reconstruction may preserve phrenic nerve function.