Background: Thoracoscopic thymectomy has shown promise in the integrated management of myasthenia gravis (MG) although there is still scant data on tong-term results. The aim of this study was to analyze tong-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 ail patients with annual follow-up. Anti-MuSK antibody titer was also assessed at the last follow-up. Results: There were 21 females and 11 mates 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 tong-term results in patients with nonthymomatous myasthenia gravis although anti-MuSK positivity correlated with poor response to operation. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.

Pompeo, E., Tacconi, F., Massa, R., Mineo, D., Nahmias, S., & Mineo, T.c. (2009). Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. In European Journal of Cardio-thoracic Surgery (pp.164-169). AMSTERDAM : ELSEVIER SCIENCE BV [10.1016/j.ejcts.2009.02.021].

Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis

POMPEO, EUGENIO;TACCONI, FEDERICO;MASSA, ROBERTO;MINEO, TOMMASO CLAUDIO
2009

Abstract

Background: Thoracoscopic thymectomy has shown promise in the integrated management of myasthenia gravis (MG) although there is still scant data on tong-term results. The aim of this study was to analyze tong-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 ail patients with annual follow-up. Anti-MuSK antibody titer was also assessed at the last follow-up. Results: There were 21 females and 11 mates 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 tong-term results in patients with nonthymomatous myasthenia gravis although anti-MuSK positivity correlated with poor response to operation. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
Annual meeting of the European association for cardio-thoracic-surgery
Lisbon
2008
22.
European association for cardio-thoracic-surgery
Rilevanza internazionale
contributo
2008
Settore MED/21 - Chirurgia Toracica
English
azathioprine; cholinergic receptor antibody; pyridostigmine; steroid; adult; antibody blood level; article; blood sampling; clinical article; disease duration; female; follow up; hospitalization; human; human tissue; length of stay; male; medical record review; morbidity; mortality; myasthenia gravis; priority journal; prognosis; remission; retrospective study; steroid therapy; symptom; thoracoscopy; thymectomy
Intervento a convegno
Pompeo, E., Tacconi, F., Massa, R., Mineo, D., Nahmias, S., & Mineo, T.c. (2009). Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. In European Journal of Cardio-thoracic Surgery (pp.164-169). AMSTERDAM : ELSEVIER SCIENCE BV [10.1016/j.ejcts.2009.02.021].
Pompeo, E; Tacconi, F; Massa, R; Mineo, D; Nahmias, S; Mineo, Tc
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/2108/28774
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