Thymectomy for Myasthenia Gravis
Mahmoud Abou EI-Seoud Diab;
Abstract
MG is an autoimmune disorder characterized by weakness and fatigue of the voluntary muscles which increases with repetitive muscle contractions, and is improved by rest and/or cholinerngic dugs. It results from the binding of antibodies to acetylcholine receptor:; causing a decrease in the free acetylcholine receptors at the neuromuscular junction. The relationship between MG and the thymus was first noted by Weigert in 1901 ( Drachman, 1994).
Medical treatment of MG involves the use of anticholinesterase agents, immunosuppressive drugs, plasmapheresis, and gammaglobulin. However, these agents result in a complete clinical remission rate as low as 15%. Accordingly, thymectomy has become increasingly effective therapeutic procedure for MG, with reported complete clinical remission rates as high as 80 %(Masaoka, 1996).
The aim of this study was to show the results of thymectomy for MG. Between Jan 1998& Jan 2002, 20 patients underwent trans-sternal tilynH.octOiliY for M(j according to tile described protocol. TillS involves sternotomy with excision of the entire thymus and pericardi.al fat from phrenic nerve to the other phrenic nerve.
50% of patients had complete rcnussJon, 30%phar/nacologic;il remission. The rest of patients either improved 111 clinic.al stage or medication requirements.
The incidence of postoperative complications was 15% (N=3). 2 cases of superficial wound infection, 1 case of pneumohia, and no mortality.
Medical treatment of MG involves the use of anticholinesterase agents, immunosuppressive drugs, plasmapheresis, and gammaglobulin. However, these agents result in a complete clinical remission rate as low as 15%. Accordingly, thymectomy has become increasingly effective therapeutic procedure for MG, with reported complete clinical remission rates as high as 80 %(Masaoka, 1996).
The aim of this study was to show the results of thymectomy for MG. Between Jan 1998& Jan 2002, 20 patients underwent trans-sternal tilynH.octOiliY for M(j according to tile described protocol. TillS involves sternotomy with excision of the entire thymus and pericardi.al fat from phrenic nerve to the other phrenic nerve.
50% of patients had complete rcnussJon, 30%phar/nacologic;il remission. The rest of patients either improved 111 clinic.al stage or medication requirements.
The incidence of postoperative complications was 15% (N=3). 2 cases of superficial wound infection, 1 case of pneumohia, and no mortality.
Other data
| Title | Thymectomy for Myasthenia Gravis | Other Titles | استئصال الغدة الثيموذية فى حالات وهن العضلات | Authors | Mahmoud Abou EI-Seoud Diab | Issue Date | 2002 |
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