Thymectomy for myasthenia gravis: a 27-year experience1

Venuta, Federico; Rendina, Erino Angelo; Giacomo, Tiziano De; Rocca, Giorgio Della; Antonini, Giovanni; Ciccone, Anna Maria; Ricci, C.; Coloni, Giorgio F.

doi:10.1016/s1010-7940(99)00052-4

Cited by 84 publications

(70 citation statements)

References 18 publications

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“…Ozdemir et al (18) found a 7-fold increased risk of clinical worsening in patients with stage IIb and III disease. Nieto et al (8) found that patients with stage I and III disease had a better outcome than those with other stages.…”

Section: Resultsmentioning

confidence: 99%

Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

Muhammed

Chen

Hitam

et al. 2016

MJMS

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Background: A thymectomy is considered effective for patients with myasthenia gravis (MG).Although a few studies have described the role of a thymectomy in the treatment of MG in Asians countries, there are no published data on the application of this surgical approach for MG in Malaysia. We aimed to describe the clinical outcomes of MG patients who underwent a thymectomy and the factors affecting these outcomes.Methods: This was a retrospective study involving 16 patients with MG who underwent a thymectomy at the Hospital Universiti Sains Malaysia (HUSM) from January 2002 until December 2012, with a follow-up period ranging from 3-120 months.Results: The study consisted of 16 patients aged 22-78 years, 10 of whom were males. The overall remission/improvement rate was 87.5%, and the rate of clinical outcomes classified as unchanged/ worsened was 12.5%. Thymomamatous or non-thymomamatous MG, histology features, Osserman stage and the duration of follow-up were not significant prognostic factors. Post-operative mortality was 6.2% (1 of 16 patients died of septic shock).Conclusion: A thymectomy seems to be an effective treatment for MG, with low surgical morbidity. Patients with a lower Osserman stage and those with/without thymomas had favourable outcomes.

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Section: Resultsmentioning

confidence: 99%

Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

Muhammed

Chen

Hitam

et al. 2016

MJMS

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“…They concluded that remission rate (RR), raised in: patients operated shortly after diagnosis, generalized mild-to-moderate MG, and involuted thymus (24). Venuta et al in their 27-year experience review reported a 25% CSR at the 10-year follow-up (23).…”

Section: Patient and Tumor Characteristicsmentioning

confidence: 99%

Clinical outcomes of CO2-less single-port video-assisted thoracoscopic thymectomy versus open thymectomy: comparative study

2016

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Background: Although video-assisted thoracoscopic surgery (VATS) for thymic disorders has been introduced, its oncological outcome and benefits over others open approaches remains unclear. Single-port VATS thymectomy using a flexible port and CO 2 has been described. However, VATS thymectomy is possible by a single incision of 3 cm without CO 2 insufflation or special port device avoiding objections related to CO 2 insufflation and allowing instruments to move more freely making procedure easier and cheaper. Our institutional experience in open and CO 2 -less VATS single-port thymectomy was retrospectively reviewed to evaluate compared to sternotomy, the clinical and oncological outcomes with this novel approach. recurrence was observed, distributed as follows: loco-regional 75% and 25% at distance; free disease period of these patients was 8.3 months. Thymectomy associated with myasthenia gravis (MG) was observed in 6 (33%) patients in the VATS group and 32 (48%) patients for sternotomy; our results regarding thymectomy for the treatment of MG were established by the MG post-intervention status [complete stable remission (CSR), pharmacologic remission, minimal manifestations, improved, unchanged and worse exacerbation, and died of MG] and reflected similar results in both approaches.Conclusions: CO 2 -less VATS single-port thymectomy is a feasible and safe procedure. Oncologic outcomes are similar to open approaches. Complications, surgical time and hospital stay are shorter compared with sternotomy. This is an initial experience, further work is required to evaluate long-term results.

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“…In the same year, Minniti et al [5] described two other cases of neoplastic masses in the middle mediastinum, only one of which was a thymoma and the other was a thymic cyst. The great experience of Venuta et al [6] correlated the results of thymectomy in the treatment of myasthenia gravis, concluding that patients suffering from thymomas present an unfavorable prognostic. Everything seems to indicate, from the 232 thymectomies performed by these authors 62 thymomas were located in the upper anterior mediastinum, if not this rare fact would have been mentioned.…”

Section: Fig 2 -Pre-operative Computer Tomography (A) and Chest Radimentioning

confidence: 99%

“…Revision of publications made by Minniti et al [5] did not find reports of thymomas in the middle mediastinum; these authors described a case of thymoma and one of a thymic cyst in the same region. Venuta et al [6] emphasized the value of thymectomy in the treatment of myasthenia gravis, as thymomas in 28.4% of the cases negatively influence the prognosis of treatment.…”

Section: Introductionmentioning

confidence: 99%

<![CDATA[<B>Middle mediastinal thymoma</B>: <B>case report</B>]]>

Kall�s¹,

Hueb²,

Kall�s³

et al. 2005

Braz. j. cardiovasc. surg.

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We report on a case of a 55-year-old female patient, who presented with clinical signs suggestive of myasthenia gravis over a period of approximately 3 months. The therapeutic option using neostigmine gave an improvement of the dysphagia and palpebral ptosis. A chest radiograph demonstrated a mass occupying the medium mediastinum with projection to the right. Computed tomography of the thorax revealed the presence of a mass in the medium mediastinum and thus surgery was indicated. During the operation the mass was observed in the medium mediastinum suggesting thymoma. What caught our attention was the unusual location of the tumor, as normally thymomas are found in the upper and anterior mediastinum. Descriptors: Thymoma, surgery. Thymus neoplasms. Mediastinal neoplasms. ResumoPaciente do sexo feminino, 55 anos, branca, com sinais clínicos sugestivos de miastenia gravis há aproximadamente 3 meses. A prova terapêutica com neostigmina evidenciou melhora da disfagia e ptose palpebral. Na radiografia de tórax observou-se imagem ocupando o mediastino médio com projeção à direita. A tomografia computadorizada de tórax revelou a presença de massa no mediastino médio, sendo indicado o tratamento cirúrgico. Chamou nossa atenção a localização pouco usual, já que, preferencialmente, os timomas localizam-se no mediastino superior e anterior. A evolução pós-operatória foi boa, sem complicações.Descritores: Timoma, cirurgia. Neoplasias do timo. Neoplasias do mediastino.

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Thymectomy for myasthenia gravis: a 27-year experience1

Abstract: Thymectomy is effective in the management of patients with MG at all stages with low morbidity. Patients with thymoma present a less favorable outcome.

Cited by 84 publications

References 18 publications

Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

Thymectomy for Myasthenia Gravis: A 10-year Review of Cases at the Hospital Universiti Sains Malaysia

Clinical outcomes of CO2-less single-port video-assisted thoracoscopic thymectomy versus open thymectomy: comparative study

<![CDATA[<B>Middle mediastinal thymoma</B>: <B>case report</B>]]>

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