观察胸腔镜下膈肌折叠术治疗微创纵隔肿瘤切除造成的膈神经损伤的疗效。

膈神经损伤后，做与未做膈肌折叠手术的治疗效果进行比较。治疗性与预防性膈肌折叠的治疗过程进行比较。对患者进行症状及影像学观察。

2022年1月至2024年7月共完成纵隔肿瘤手术445例，其中手术方式包含膈肌折叠49例，其中5例纵隔肿瘤患者全胸腺切除和膈肌折叠术以微创方式完成。术前、术后患者症状及影像学观察比较显示，胸腔镜下行膈肌折叠术治疗的膈神经损伤患者，胸闷症状明显改善；预防性膈肌折叠的患者，术后未出现因膈肌膨隆而产生的呼吸困难，恢复快，术后效果良好。

在无肺切除的纵隔肿瘤切除术中，对膈神经侵犯或术中损伤的患者行胸腔镜下膈肌折叠术，可治疗或预防膈神经损伤并发症，获得满意的治疗效果。

To observe the application scope and experience of thoracoscopic diaphragmatic fold surgery in the treatment or prevention of complications of diaphragmatic nerve injury (tumor invasion or intraoperative injury).

After phrenic nerve injury, the therapeutic effects were compared between patients with and without diaphragmatic plication. Therapeutic versus prophylactic diaphragmatic plication of the treatment course was compared. The symptoms and imaging were observed.

In the period from Jan. 2022 to Jul. 2024, a total of 445 mediastinal tumor surgeries were performed, of which 49 involved the folding of the diaphragm. Among these, 5 patients underwent total thymectomy and diaphragm folding via minimally invasive surgery. Comparing the symptoms and imaging observations before and after surgery in patients with diaphragmatic nerve injury treated by thoracoscopic diaphragm folding, it was found that patients with improved symptoms of chest tightness; in patients with preventive diaphragm folding, no respiratory difficulty due to diaphragmatic bulging occurred after surgery, recovery was fast, and postoperative effects were good.

In mediastinal tumor resection without lung resection, thoracoscopic diaphragmatic folding surgery can treat or prevent complications of phrenic nerve injury in patients with phrenic nerve invasion or intraoperative injury, achieving satisfactory treatment results.