Thymectomy for Non-thymomatous Myasthenia Gravis

Sonett, Joshua R.; Bromberger, Bianca; Jaretzki, Alfred

doi:10.1007/978-3-319-73585-6_13

Cited by 8 publications

(14 citation statements)

References 130 publications

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“…Generally, thymectomy is indicated for patients diagnosed with myasthenia gravis (10). However, the appropriate surgical approaches remain arguable.…”

Section: Discussionmentioning

confidence: 99%

“…It is recommended that all the thymus including encapsulated and extracapsular tissues, should be removed during open or thoracoscopic surgery resulting in better therapeutic effect in MG patients (8)(9)(10). However, owing to the widespread distribution of ectopic thymic tissues in the anterior mediastinum, the surgical approaches are debatable.…”

Section: Introductionmentioning

confidence: 99%

“…However, the appropriate surgical approaches remain arguable. Considering the wide distribution of ectopic thymic tissues in the anterior mediastinum, most thoracic surgeons recommend to remove as much mediastinal fat tissues as possible during thymectomy to avoid leaving ectopic thymic tissues, regardless via the thoracoscopic or open approaches (5,6,10,14,22,24) (Figure 5). In the open surgery, the transsternal approach is recognized as the standard procedure for extended thymectomy.…”

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confidence: 99%

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Subxiphoid and subcostal arch “Three ports” thoracoscopic extended thymectomy for myasthenia gravis

et al. 2018

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“…Generally, thymectomy is indicated for patients diagnosed with myasthenia gravis (10). However, the appropriate surgical approaches remain arguable.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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Subxiphoid and subcostal arch “Three ports” thoracoscopic extended thymectomy for myasthenia gravis

et al. 2018

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“…Another limitation is the lack of data on thymectomy technique. Maximal resection of thymus tissue, along with early timing of thymectomy, may be associated with better outcomes . Although our results do not suggest a benefit of thymectomy, it would be of interest to have assessed whether thymectomy technique correlated with clinical outcome.…”

Section: Discussionmentioning

confidence: 76%

“…The benefit of thymectomy in AChR‐MG may plateau about 12 months after the surgery . In some cohorts, improvement after thymectomy has been reported after years of follow‐up . Although the median duration of follow‐up in the thymectomy cohort was 70 months, the majority of the thymectomy arm subjects in our cohort received thymectomy before the period of observation, which prevents a full time‐to‐event analysis of the observed effect at the 12‐month mark and final visit.…”

Section: Discussionmentioning

confidence: 88%

Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis

et al. 2019

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Introduction: A randomized trial demonstrated benefit from thymectomy in nonthymomatous acetylcholine receptor (AChR)‐antibody positive myasthenia gravis (MG). Uncontrolled observational and histologic studies suggest thymectomy may not be efficacious in anti–muscle‐specific kinase (MuSK)‐MG. Methods: The therapeutic impact of thymectomy was evaluated from data collected for a multicenter, retrospective blinded review of rituximab in MuSK‐MG. Results: Baseline characteristics were similar between thymectomy (n = 26) and nonthymectomy (n = 29) groups, including treatment with rituximab (42% vs. 45%). At last visit, 35% of thymectomy subjects reached the primary endpoint, a Myasthenia Gravis Foundation of America (MGFA) post‐intervention status (PIS) score of minimal manifestations (MM) or better, compared with 55% of controls (P = 0.17). After controlling for age at onset of MG, rituximab, prednisone, and intravenous immunoglobulin/plasma exchange treatment, thymectomy was not associated with greater likelihood of favorable clinical outcome (odds ratio = 0.43, 95% confidence interval 0.12–1.53, P = 0.19). Discussion: Thymectomy was not associated with additional clinical improvement in this multicenter cohort of MuSK‐MG patients. Muscle Nerve 59:404–410, 2019

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Technique for Myasthenia Gravis

Aramini

Jiang

2019

Thoracic Surgery Clinics

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Surgical resection of thymoma has been recommended as the principal treatment, and completeness of resection is considered the most important determinant of the long-term survival in thymomas. Recent studies have reported thymectomy for myasthenia gravis and anterior mediastinal tumors using a minimally invasive approach rather than conventional median sternotomy. Video-assisted thoracic surgery (VATS) is widely used in thoracic surgery for anterior mediastinal tumors or myasthenia gravis (MG). The subxiphoid approach led to less-invasive thymectomy and extended the indications for VATS for invasive anterior mediastinal tumors. The subxiphoid approach improves patient satisfaction, reduces pain, and offers superior aesthetic outcomes.

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Thymectomy for Non-thymomatous Myasthenia Gravis

Cited by 8 publications

References 130 publications

Subxiphoid and subcostal arch “Three ports” thoracoscopic extended thymectomy for myasthenia gravis

Subxiphoid and subcostal arch “Three ports” thoracoscopic extended thymectomy for myasthenia gravis

Thymectomy may not be associated with clinical improvement in MuSK myasthenia gravis

Technique for Myasthenia Gravis

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