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Follow-up of 50 Myasthenia Gravis Patients after Thymectomy

Author: CuiQiChen
Tutor: CuiYouBin
School: Jilin University
Course: Surgery
Keywords: myasthenia gravis thoracoscope thymectomy prognosis
CLC: R746.1
Type: Master's thesis
Year: 2011
Downloads: 16
Quote: 0
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Abstract


Objectives:Myasthenia gravis is a chronic deisease caused by an acquired autoimmune disorder leading to the failure of the neuro-muscular trasmision. The incidence of the disease in population is about 200-400/1,000,000. Thymectomy is an efficacious treatment for the disease which demonstrated by experimental and clinical studies. There are many studies that focused on the opportunity of the operation and prognostic factors. A long-term follow-up of 54 patients with myasthenia gravis, who underwent thymectomy in our department was carried out to find prognostic factors affecting therapeutic effect; and evaluate the therapeutic effect beween transsternal and the thoracoscopic approach.Methods:Clinical records of 54 patients that maked a definite diagnosis of MG who underwent the thymectomy since 2004-10 to 2010-10 were reviewed. Completing follow-up data were collected and analyzed by suitable statistic method.Results:50(92.59%)patients including 13 male and 37 female had a mean age of 39.56±17.42 at the time of operation and a mean follow-up of 29.51±17.30 months. According to Mordan standard, there are 13 patients remitted in symptoms,26 patients improved,7 patients unchanged,4 patients worse,and 3 died. Patients’ duration of symptoms preoperative and thymic pathology types correlated with postoperative improvement and remission rates, but age, sex, Osserman Stage, surgical approach are irrelevant. Compared to transsternal approaches in patients with MG, thoracoscopic approach is less invasion with losing less blood and having better recovery. There is no difference between different thymic pathology types in the incidence of crisis in statistics. There is also no difference between the group of thoracoscope and the group of transsternal in the incidence of crisis in statistics.Conclusion:Thymectomy is an effective way as the treatment for myasthenia gravis, and its effect has been affirmed. Except for some children patients with Osserman I type, the therapeutic effect is better in short-course patients, that suggest thymectomy is necessary at the early stage of MG. Compared to transstemal approach, thoracoscopic approach is much more safe, with less trauma but faster recovery. The author advocate adopting thymectomy by thoracoscopic approach if the hospital has good surgical condition.

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CLC: > Medicine, health > Neurology and psychiatry > Neurology > Neuromuscular disease > Myasthenia gravis
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