Document Detail


Preoperative steroid therapy stabilizes postoperative respiratory conditions in myasthenia gravis.
MedLine Citation:
PMID:  18340510     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We reviewed our experience from 1990 to 2005 to examine whether control of myasthenia gravis (MG) with steroid therapy before surgery could stabilize postoperative respiratory conditions, compared with the nonsteroid treatment. METHODS: Records of 43 consecutive patients with MG who underwent extended thymectomy at Kansai Medical University Hospital were retrospectively reviewed. Two groups, a steroid group (n = 28) and a nonsteroid group (n = 15) were compared. RESULTS: In the steroid group, steroid doses ranged from 10 to 100 mg every other day, or 40-60 mg daily. The patients showed significantly less thymus hyperplasia in the pathological findings (P = 0.023). Whereas 3 of 28 (7%) in the steroid group suffered respiratory insufficiency within 3 days of surgery, 5 of 15 (33%) in the nonsteroid group exhibited the same problem (P = 0.030). Univariate analysis showed that steroid treatment was the only significant factor (P = 0.041) affecting respiratory insufficiency. Patients in the steroid group achieved palliation of MG more quickly after surgery than patients in the nonsteroid group (86% vs. 57% within 6 months, P = 0.059; 84% vs. 42% within 1 year, P = 0.042). CONCLUSION: The control of myasthenia gravis with steroid therapy before surgery seems to stabilize postoperative respiratory status without having adverse effects on surgical infection.
Authors:
Hiroyuki Kaneda; Yukihito Saito; Tomohito Saito; Tomohiro Maniwa; Ken-Ichiro Minami; Hirohumi Kusaka; Hiroji Imamura
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2008-03-14
Journal Detail:
Title:  General thoracic and cardiovascular surgery     Volume:  56     ISSN:  1863-6705     ISO Abbreviation:  -     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-03-14     Completed Date:  2008-06-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101303952     Medline TA:  Gen Thorac Cardiovasc Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  114-8     Citation Subset:  IM    
Affiliation:
Department of Thoracic and Cardiovascular Surgery, Kansai Medical University Hirakata Hospital, 2-3-1 Shinmachi, Hirakata, Osaka, 573-1191, Japan. kanedah@hirakata.kmu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Ambenonium Chloride / therapeutic use
Cholinesterase Inhibitors / therapeutic use
Combined Modality Therapy
Female
Humans
Logistic Models
Male
Middle Aged
Myasthenia Gravis / drug therapy*,  prevention & control,  surgery*
Prednisolone / administration & dosage*
Preoperative Care*
Respiratory Insufficiency / prevention & control*
Retrospective Studies
Thymectomy*
Chemical
Reg. No./Substance:
0/Cholinesterase Inhibitors; 115-79-7/Ambenonium Chloride; 50-24-8/Prednisolone
Comments/Corrections
Comment In:
Gen Thorac Cardiovasc Surg. 2008 Mar;56(3):95-6   [PMID:  18340506 ]

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


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