Impact of Phrenic Nerve Repair Using Intercostal Nerve Graft on Diaphragm Function after Thoracic Tumour Resection

This retrospective study investigated whether phrenic nerve repair with intercostal nerve graft affects postoperative diaphragmatic motion and respiratory function after thoracic tumour resection.

We included 11 consecutive patients (reconstruction group: n = 8; nonreconstruction group: n = 3) who underwent thoracic tumour resection with phrenic nerve removal between October 2023 and March 2025. In the reconstruction group, the intercostal and phrenic nerves were connected end-to-end using 5-0 or 6-0 Prolene sutures. Postoperative respiratory function, inspiratory/expiratory diaphragm movement distance (IEDD), and inspiratory/expiratory lung area (IEA) ratio on chest X-ray were measured using SYNAPSE VINCENT and compared between the 2 groups.

No significant differences in age, sex, and side of phrenic nerve resected were observed between the 2 groups. IEDD ≥10 mm within 1 month postoperatively was seen in 4 (50%) patients in the reconstruction group. Mean IEDD on X-ray was 19.8 mm vs 4.1 mm (P = .013) at 1-3 months and 19.8 mm vs 4.4 mm (P = .031) at 4-6 months for the reconstruction and nonreconstruction groups, respectively. Mean IEA ratios were 1.16 vs 1.04 (P = .026) at 1-3 months and 1.19 vs 1.05 (P = .031) at 4-6 months, respectively. Postoperative respiratory function showed higher %VC (78% vs 56%, P = .008) and %FEV1 (72% vs 45%, P < .001) in the reconstruction group at 4-6 months.

Phrenic nerve repair with intercostal nerve graft mitigated diaphragmatic dysfunction and maintained postoperative respiratory function after phrenic nerve resection.

2024 Eki-102.