| Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. | |
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MedLine Citation:
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PMID: 19339195 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Thoracoscopic thymectomy has shown promise in the integrated management of myasthenia gravis (MG) although there is still scant data on long-term results. The aim of this study was to analyze long-term (>5 years) results of thoracoscopic extended thymectomy in nonthymomatous MG. METHODS: We retrospectively reviewed 32 patients operated on between 1995 and 2003. MG foundation of America clinical classification (MGFA), symptoms' duration, preoperative crisis, anticholinesterase-drugs dosage, steroid use, and acetylcholine receptor antibodies were evaluated in all patients with annual follow-up. Anti-MuSK antibody titer was also assessed at the last follow-up. RESULTS: There were 21 females and 11 males with a median age of 36 years. Ten patients were seronegative for acetylcholine receptor antibodies. Patients in MGFA class I, II, III and IV were 7 (22%), 15 (44%), 9 (28%), 2 (6%) patients, respectively. Median symptoms duration was 11 months. There was no mortality or major morbidity. Median hospital stay was 4.0 days. Ectopic thymic tissue was found in 18 (56%) patients. Median follow-up was 119 months (range 60-156 months). There was no residual thoracic pain. Estimated 10-year remission rate was 50%. At 72 months, 27 (84.3%) patients were improved or in complete remission. At the univariate analysis, shorter duration of symptoms (<12 months) and absence of oropharyngeal involvement were both predictors of response to thymectomy (p<0.02) whereas positivity for anti-MuSK antibody was a predictor of non-response (p=0.0007). CONCLUSIONS: Thoracoscopic extended thymectomy yields satisfactory long-term results in patients with nonthymomatous myasthenia gravis although anti-MuSK positivity correlated with poor response to operation. |
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Authors:
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Eugenio Pompeo; Federico Tacconi; Roberto Massa; Davide Mineo; Sarit Nahmias; Tommaso Claudio Mineo |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2009-03-31 |
Journal Detail:
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Title: European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery Volume: 36 ISSN: 1873-734X ISO Abbreviation: Eur J Cardiothorac Surg Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-06-22 Completed Date: 2009-10-19 Revised Date: 2009-11-19 |
Medline Journal Info:
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Nlm Unique ID: 8804069 Medline TA: Eur J Cardiothorac Surg Country: Germany |
Other Details:
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Languages: eng Pagination: 164-9 Citation Subset: IM |
Affiliation:
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Department of Thoracic Surgery, Myasthenia Gravis Unit, Policlinico Tor Vergata University, Rome, Italy. pompeo@med.uniroma2.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Autoantibodies / blood Biological Markers / blood Choristoma / complications Female Follow-Up Studies Humans Male Middle Aged Myasthenia Gravis / complications, surgery* Receptor Protein-Tyrosine Kinases / immunology Receptors, Cholinergic / immunology Remission Induction Retrospective Studies Thoracic Surgery, Video-Assisted / methods* Thymectomy / methods* Thymus Gland Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Autoantibodies; 0/Biological Markers; 0/Receptors, Cholinergic; EC 2.7.10.1/MUSK protein, human; EC 2.7.10.1/Receptor Protein-Tyrosine Kinases |
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