RT Journal Article SR Electronic T1 Surgery for late blunt traumatic diaphragmatic lesion JF European Respiratory Journal JO Eur Respir J FD European Respiratory Society SP p2397 VO 38 IS Suppl 55 A1 Danail Petrov A1 Michail Plochev A1 Elyuar Goranov A1 Georgi Yankov A1 Svilen Alexov A1 Rossen Petkov YR 2011 UL http://erj.ersjournals.com/content/38/Suppl_55/p2397.abstract AB Objective: To evaluate the efficacy of surgery in the blunt traumatic diaphragmatic lesions.Material and methods: From 1990 to 2010 a total of 24 patients (pts) (3 female and 21 male, mean age 47.1y) were operated on. Time from trauma to surgery varied between 4 months to 8 years. The left hemidiaphragm was injured in 17 cases, while the right one in 7. The thoracic trauma was associated with other injuries in 10 pts. In 3pts incarceration of herniated visceral segment was observed. In 2 pts herniated stomach has been drained for “pneumothorax” and emergency surgery was carried out.Results: Laparotomy was applied in 3 pts with stomach volvulus. In 21 cases thoracotomy was the surgical approach. Stomach, colon, small bowl, omentum and spleen were most frequently found to herniated through the left diaphragmatic defects, whereas colon and lever were mostly seen in the right enterothorax. In 1 patient transthoracic splenectomy was carried out because of a severe induration. Dense adhesions were found in all cases. Mayo technique was performed in 19 pts for diaphragmatic repair. Marlex mesh was used in 4 pts and in 1 case an original technique for repair of enormous diaphragmatic defect with pericardial flap was carried out. Uneventful postoperative period was observed in all but one (pulmonary embolism, successfully treated). The mean in-hospital stay was 12.1 days. No relapse of the diaphragmatic lesion 1 to 16 years after the operation.Conclusions: Patients with diaphragmatic rupture presenting in the late phase have adhesion between the herniated abdominal and intrathoracic organs, and thus the rupture is best approached and repaired via a thoracotomy, followed by very good early and long-term postoperative results.