Diaphragm elevation after lobectomy: defining its extent, duration, and diagnostic significance

İngilizce (OpenAlex)

Background: Diaphragmatic elevation is among the earliest compensatory changes following lung resection; however, its extent and duration remain inadequately defined. Materials and Methods:A retrospective analysis was conducted on 198 patients who underwent surgical treatment for non-small cell lung cancer between January 2022 and June 2023.Of these, 102 patients who underwent upper or lower lobectomy were included in the study.Diaphragmatic position was assessed using chest radiographs obtained preoperatively and on postoperative days 1, 10, and 30.Measurements were performed by independent radiologists and compared according to surgical approach (VATS vs. thoracotomy), lobectomy location (upper vs. lower), and operative side (right vs. left).Results: Significant diaphragmatic elevation was observed on the first postoperative day and persisted through day 10.The mean difference between preoperative and postoperative day 1 measurements was 29.16 ± 12.93 mm (p < 0.0001).Partial recovery was noted by day 10 (p < 0.001).Both hemidiaphragms showed similar patterns, although the right hemidiaphragm demonstrated greater recovery.No significant associations were identified between diaphragmatic elevation and surgical approach, lobectomy location, or laterality (p > 0.05 for all comparisons).Conclusions: Diaphragmatic elevation represents a normal anatomical adaptation in the early postoperative period following lung resection.Defining its expected extent and duration may facilitate the early recognition of postoperative complications.Larger-scale studies are warranted to establish definitive reference criteria for postoperative diaphragmatic elevation.