Abstract

Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG). To describe the immediate and long-term results of extended transsternal thymectomy (ETT) in patients with MG. A review of databases, surgical protocols, clinical records and interviews of patients subjected to extended transsternal thymectomy for MG between 1990 and 2016. Perioperative clinical characteristics, anticholinesterase treatment, immediate and remote surgical results were analyzed and patients were followed from one to 10years. We studied 58 patients aged 35 ± 14years (72%) women. In the preoperative period, according to Osserman classification, nine patients (15,5%) were in grade I, eight (13,8%) in grade IIA 8 and 40 (69%) in grade IIB. The pathological study of the surgical piece showed thymic hyperplasia in 39 cases (67,2%). Four patients had postoperative complications but none died. In the Follow-up at 1, 3, 5, 8 and 10years the Masaoka palliation rate was 71.7, 77.5, 67.7, 70.0 and 70,6% respectively. The figures for remission rate were 13.0, 15.0,19.4, 35.0 and 35,3% respectively. The figures for Zielinski positive results were 79.6, 87.5, 87.1, 90.0 and 82,4% respectively. The DeFilippi score improved by 80.4, 87.5, 87.1, 90.0 and 82.4% respectively. The Myasthenia Gravis Foundation of America Post-Intervention State improved by 67.4, 77.5, 77.5, 75.0 and 70,6% respectively. Mean Myasthenia Gravis Activities of daily living (MGADL) and Myasthenia Gravis Quality of life scale 15 (MGQOL 15) were 1.65 and 6.31 respectively. In selected patients with MG, extended transsternal thymectomy in MG has good immediate and long-term results.

Highlights

  • Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG)

  • Material and Methods: A review of databases, surgical protocols, clinical records and interviews of patients subjected to extended transsternal thymectomy for MG between 1990 and 2016

  • We studied 58 patients aged 35 ± 14 years (72%) women

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Summary

ARTÍCULO DE INVESTIGACIÓN

Neurología, Hospital Clínico Regional de Concepción: “Dr Guillermo Grant Benavente”, Concepción, Chile. 5Departamento de Especialidades, Concepción, Chile. 6Servicio de Cirugía, Hospital. Neurología, Hospital Clínico Regional de Concepción: “Dr Guillermo Grant Benavente”, Concepción, Chile. No existen conflictos de interés ni apoyo financiero. Recibido el 28 de septiembre de 2017, aceptado el 11 de abril de 2018. Correspondencia a: Roberto González Lagos Departamento de Cirugía, Facultad de Medicina, Universidad de Concepción, Janequeo esquina Chacabuco

Material suplementario en versión digital de la Revista Médica de
Background
Material y Método
Se describe y compara características clínicas
Histología Hiperplasia tímica Timoma Atrofia tímica
Full Text
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