Comparative Clinical Outcomes of Thymectomy for Myasthenia Gravis Performed by Extended Transsternal and Minimally Invasive Approaches

Meyer, Dan M.; Herbert, Morley A.; Sobhani, Nasin C.; Tavakolian, Paul; Duncan, Andrea F.; Bruns, Michelle; Korngut, Kevin; Williams, Janet L.; Prince, Syma L.; Huber, Lynne M.; Wolfe, Gil I.; Mack, Michael J.

doi:10.1016/j.athoracsur.2008.11.040

Cited by 130 publications

(85 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, their method was applied even to invasive thymoma cases, while we restricted to only non-invasive and less than 5cm lesions. Recently, it has been reported that comparative clinical outcomes between extended trans-sternal and VATS are equivalent [5,6]. Short-term results of our patients are encouraging.…”

Section: Resultsmentioning

confidence: 58%

See 1 more Smart Citation

Video-Thoracoscopic Extended Thymectomy with Sternal Elevation and Carbon Dioxide Insufflation

Fukai¹,

Inoue²,

Araki³

et al. 2015

Journal of Case Reports and Studies

View full text Add to dashboard Cite

Keywords: Sternal elevation; Carbon dioxide (CO 2 ) insufflation To remove the thymus safely and completely in the surgical management for MG, especially for the upper pole of the thymus in the neck, we have performed video-thoracoscopic extended thymectomy (VATET) with sternal elevation and carbon dioxide (CO 2 ) insufflation. From November 2013 to May 2014, we conducted VATET for three MG patients. Symptomatic improvement was obtained, and there was neither mortality nor perioperative complications. VATET with sternal elevation and CO 2 insufflation was a safe and valid technique for thymectomy for MG. Clinical short-term results were satisfactory.

show abstract

Section: Resultsmentioning

confidence: 58%

“…Surgical options for thymectomy include a trans-sternal approach, a transcervical approach, a combined transcervical-transsternal maximum thymectomy, and VATS [3][4][5]. Takeo et al reported Video-assisted extended thymectomy in patients with thymoma by lifting the sternum [4].…”

Section: Resultsmentioning

confidence: 99%

Video-Thoracoscopic Extended Thymectomy with Sternal Elevation and Carbon Dioxide Insufflation

Fukai¹,

Inoue²,

Araki³

et al. 2015

Journal of Case Reports and Studies

View full text Add to dashboard Cite

show abstract

“…Meyer et al [35] compared video-assisted thymectomy with the extended transsternal approach in a retrospective study. Video-assisted thoracoscopic surgery (VATS) was performed in 48 patients, and transsternal approach was performed in 47 patients.…”

Section: Surgical Methodsmentioning

confidence: 99%

Thymectomy in Myasthenia Gravis

Aydın¹,

Ulaş²,

Mutlu³

et al. 2017

Eurasian J Med

View full text Add to dashboard Cite

In recent years, thymectomy has become a widespread procedure in the treatment of myasthenia gravis (MG). Likelihood of remission was highest in preoperative mild disease classification (Osserman classification 1, 2A). In absence of thymoma or hyperplasia, there was no relationship between age and gender in remission with thymectomy. In MG treatment, randomized trials that compare conservative treatment with thymectomy have started, recently. As with non-randomized trials, remission with thymectomy in MG treatment was better than conservative treatment with only medication. There are four major methods for the surgical approach: transcervical, minimally invasive, transsternal, and combined transcervical transsternal thymectomy. Transsternal approach with thymectomy is the accepted standard surgical approach for many years. In recent years, the incidence of thymectomy has been increasing with minimally invasive techniques using thoracoscopic and robotic methods. There are not any randomized, controlled studies which are comparing surgical techniques. However, when comparing non-randomized trials, it is seen that minimally invasive thymectomy approaches give similar results to more aggressive approaches.Keywords: Extended thymectomy, follow-up, myasthenia gravis, thoracoscopic thymectomy ÖZ Miyastenia gravis tedavisinde son yıllarda timektomi giderek yaygınlaşan bir prosedür haline geldi. Preoperatif hafif hastalık sınıflaması (Osserman sınıflaması 1, 2A) olanlarda remisyon ihtimali en yüksek olarak gösterildi. Timoma veya hiperplazi yokluğunda timektomi ile remisyon sağlamada yaş ve cinsiyetin ilişkisi gösterilemedi. Miyastenia gravis tedavisinde timektomi ile konservatif tedaviyi karşılatıran randomize çalışmalar yeni yayınlanmaya başlandı. Nonrandomize çalışmalarda olduğu gibi Miyastenia gravis tedavisinde timektomi ile remisyon, sadece ilaçla konservatif tedaviden daha iyi bulundu. Cerrahi yaklaşım için transservikal, minimal invaziv, transsternal ve kombine transservikal transsternal timektomi olmak üzere dört major yöntem bulunmaktadır. Transsternal yaklaşımla timektomi yıllardır kabul gören standart cerrahi yaklaşımdır. Son yıllarda torakoskopik ve robotik yöntemin kullanıldığı minimal invaziv tekniklerle timektomi sıklığı artmaktadır. Cerrahi teknikleri karşılaştıran randomize, kontrollü çalışmalar bulunmamaktadır. Ancak nonrandimize çalışmalar arasındaki karşılaştırmalara bakıldığında minimal invaziv timektomi yaklaşımlarının daha agresif yaklaşımlara benzer sonuçlar verdiği görülmektedir.

show abstract

“…VATS thymectomy has great advantage over sternotomy because of avoidance of muscle division and bone fractures, allowing for diminished duration and intensity of pain and shorter time to return to full activity [19]. Previous studies comparing different operative techniques showed that VATS thymectomy produced a long-term clinical outcome equivalent to that of the extended sternal approach, with lower complication rates [20,21]. Although some of the reports have suggested the need to perform a bilateral VATS, most perform from the right chest [22].…”

Section: Human Cadavermentioning

confidence: 99%

Hybrid endoscopic thymectomy: combined transesophageal and transthoracic approach in a survival porcine model with cadaver assessment

et al. 2014

View full text Add to dashboard Cite

Comparative Clinical Outcomes of Thymectomy for Myasthenia Gravis Performed by Extended Transsternal and Minimally Invasive Approaches

Cited by 130 publications

References 18 publications

Video-Thoracoscopic Extended Thymectomy with Sternal Elevation and Carbon Dioxide Insufflation

Video-Thoracoscopic Extended Thymectomy with Sternal Elevation and Carbon Dioxide Insufflation

Thymectomy in Myasthenia Gravis

Hybrid endoscopic thymectomy: combined transesophageal and transthoracic approach in a survival porcine model with cadaver assessment

Contact Info

Product

Resources

About