Document Detail


Combined transcervical and unilateral-thoracoscopic thymectomy for myasthenia gravis: 2 years of follow-up.
MedLine Citation:
PMID:  18936673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To investigate the efficacy of combined transcervical and unilateral-thoracoscopic thymectomy for myasthenia gravis. METHODS: There were 36 patients with nonthymomatous myasthenia gravis, undergoing combined transcervical and unilateral-thoracoscopic thymectomy and who have been followed-up for more than 2 years. To achieve maximal benefit, a transverse cervical incision was performed to give access to remove fat in the neck, which may contain residual or ectopic thymus after all thymic tissue and mediastinal fat were completely removed by thoracoscopic thymectomy. RESULTS: There were no perioperative deaths and no cases that required conversion to median sternotomy. The mean length of surgery was 162 minutes (range, 132 to 210 min). Three sustained myasthenic crisis. Seventeen patients had lymphadenitis and 4 had ectopic thymus in the neck. There were 2 cases in which the residual superior horns of thymus were found in the neck. Average specimen weights of the thymus, mediastinal fat, and cervical fat were 44.2, 32.5, and 3.6 g, respectively. The rate of complete stable remission was 16.7% at the end of the first year, and rose to 27.8% at the second year. The effective rate was 88.9% at the end of the second year. CONCLUSIONS: Thymectomy represents a safe and valid approach for patients with myasthenia gravis. Achieving a curative thymectomy and good cosmesis in myasthenic patients is possible with the combined transcervical and unilateral-thoracoscopic thymectomy as an effective alternative to open approaches.
Authors:
Lei Yu; Ma Shan; Jian Jiang; Yun Jing; Nan Zang; Tianyou Wang; Ziv Gamliel; Mark J Krasna
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Surgical laparoscopy, endoscopy & percutaneous techniques     Volume:  18     ISSN:  1534-4908     ISO Abbreviation:  Surg Laparosc Endosc Percutan Tech     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2008-12-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888751     Medline TA:  Surg Laparosc Endosc Percutan Tech     Country:  United States    
Other Details:
Languages:  eng     Pagination:  489-92     Citation Subset:  IM    
Affiliation:
Department of Thoracic Surgery and Neurology, Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing, China. yulei1118@sohu.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Female
Humans
Male
Middle Aged
Myasthenia Gravis / surgery*
Thoracic Surgery, Video-Assisted*
Thymectomy / methods*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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