Surgical reinnervation as a method for treating diaphragmatic paralysis: from experimental foundations to clinical application

Background. The study of surgical reinnervation techniques is of growing interest due to the limitations of existing therapeutic approaches for diaphragmatic paralysis caused by phrenic nerve injury. Traditional diaphragm plication, a palliative procedure, fails to restore its natural innervation and contractile function, necessitating the development of more effective treatments. Objective. To conduct a comprehensive analysis of modern data on the possibilities of surgical reinnervation in treating paralysis of the diaphragm, evaluate the morphofunctional foundations of the method, and determine the prospects of its clinical application. Material and methods. An analysis of scientific publications was conducted, including experimental studies on animal models and clinical observations. The literature search was carried out in the PubMed, Google Scholar and eLibrary databases using key terms related to the research topic. Results. The analysis systematizes current knowledge on the surgical reinnervation of the diaphragm. Experimental animal studies confirm the fundamental feasibility of restoring diaphragmatic function using various donor nerves. Clinical evidence demonstrates the efficacy and safety of primary surgical strategies, including neurolysis, autografting, and neurotization of the phrenic nerve. Conclusion. Surgical reinnervation is a promising treatment for diaphragmatic paralysis, showing clinically significant outcomes. Further research is required to optimize clinical results and enable widespread adoption. This should focus on standardizing techniques, determining optimal timing for intervention, and conducting randomized clinical trials with long-term follow-up.