scholarly journals Analysis on the Clinical Effect of High-Dose Glucocorticoids Combined with Immunosuppressants on Patients with Myasthenia Gravis Undergoing Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Pei Liu ◽  
Haoyue Wang ◽  
Jiejie Hu ◽  
Xiaobin Zhai ◽  
Zhaoming Ge
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Efficacy ◽  
Clinical Effect ◽  
Clinical Symptoms ◽  
Thoracoscopic Surgery ◽  
Control Group ◽  
High Dose ◽  
Video Assisted ◽  
Experimental Group ◽  
Video Assisted Thoracoscopic Surgery

Objective. The purpose of the study was to investigate the clinical effect of high-dose glucocorticoids (GCS) combined with immunosuppressants on the treatment of myasthenia gravis (MG) with video-assisted thoracoscopic surgery (VATS). Methods. A total of 106 MG patients admitted to the neurology department of our hospital from February 2016 to February 2020 were selected as the study subjects and divided into experimental group ( n = 53 ) and control group ( n = 53 ). The patients in the control group underwent VATS, while the patients in the experimental group were treated with high-dose GCS combined with immunosuppressants on the basis of VATS treatment. The clinical efficacy of different MG treatment methods was analyzed. Results. No significant differences were observed in visual analogue score (VAS) at T1 between the two groups ( P > 0.05 ), while VAS scores at T2, T3, and T4 in the experimental group were significantly lower than those in the control group ( P < 0.001 ). In the experimental group, the overall response rate was significantly higher than the control group ( P < 0.05 ). Cytotoxic T-lymphocyte-associated protein 4 (CTLA4) level in regulatory T (Treg) cells in experimental groups after treatment was significantly higher, compared to that in before treatment and the control group ( P < 0.05 ). Similar results of each quantitative MG score were displayed in both groups after treatment, compared to before treatment and the control group ( P < 0.05 ). Clinical performance of patients with lower incidence of adverse reactions in the experimental groups after treatment was significantly higher than those in the control group ( P < 0.001 ). Conclusion. GCS combined with immunosuppressants can effectively relieve patients’ clinical symptoms and improve their quality of life, with significant clinical efficacy and high safety, which is worthy of application and promotion.

Myasthenia gravis miatt végzett három különböző típusú csecsemőmirigy-eltávolítás sebészeti és korai neurológiai eredményei

2015 ◽  
Vol 68 (6) ◽  
pp. 219-224
Author(s):  
Aurél Ottlakán ◽  
Tibor Géczi ◽  
Balázs Pécsy ◽  
Bernadett Borda ◽  
Judit Lantos ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Extended Thymectomy ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

Absztrakt Célkitűzés: A myasthenia gravis (MG) kezelésében számos nyitott, illetve minimálisan invazív thymectomia ismert. A tanulmány ugyanazon intézeten belül a transsternalis (TS), illetve kétféle minimálisan invazív thymectomia (video-assisted thoracoscopic extended thymectomy – VATET; unilateral video-assisted thoracoscopic surgery – UL-VATS) eredményeit hasonlítja össze. Anyag és módszerek: Három különböző időintervallumban 71 betegnél történt thymectomia MG miatt (60 nő, 11 férfi): 23 transsternalis thymectomia (1995. január–2004. szeptember), 22 VATET (2004. szeptember – 2009. augusztus) és 26 UL-VATS thymectomia (2009. szeptember – 2011. december). Az eredmények értékelésénél a műtéti idő, MG-hez társuló neurológiai és a műtét utáni sebészi szövődmények, valamint az MG státuszában az egyéves utánkövetéskor észlelt neurológiai változások szerepeltek. Eredmények: Perioperatív mortalitás nem fordult elő. A műtéti idő 112, 211, 116 perc (p = 0,001), a kórházi napok száma: 8,9, 5,6 és 4 nap (p = 0,001) volt a TS-, VATET- és UL-VATS-csoportban. Az MG-hez kapcsolódó postoperativ neurológiai szövődmények 21,7%, 18,2% és 7,7% (p = 0,365) értékeket mutattak. A sebészi szövődmény 4,3%, 13,7%, 0% (p = 0,118) volt. Az MG tüneteinek javulása 91,3%, 94,7%, 87,5% (p = 0,712), míg komplett remisszió 13%, 10,5%, 11,5% (p = 0,917) volt a TS-, VATET- és UL-VATS-csoportokban. Következtetések: A műtéti idő, valamint a kórházban eltöltött napok száma UL-VATS esetében volt a legrövidebb. A kisebb sebészi beavatkozáshoz alacsonyabb sebészi, illetve MG-s neurológiai szövődmények társultak. Az MG-tünetek javulásában mindhárom módszernél kiváló eredményt értek el.

scholarly journals High-dose methylprednisolone in video-assisted thoracoscopic surgery lobectomy: a randomized controlled trial†

2017 ◽  
Vol 53 (1) ◽  
pp. 209-215 ◽  
Author(s):  
Lars S Bjerregaard ◽  
Per F Jensen ◽  
Dennis R Bigler ◽  
René Horsleben Petersen ◽  
Hasse Møller-Sørensen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
High Dose ◽  
Randomized Controlled ◽  
Video Assisted ◽  
High Dose Methylprednisolone ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Predictors and Clinical Outcomes in Empyema Thoracis Patients Presenting to the Emergency Department Undergoing Video-Assisted Thoracoscopic Surgery

2019 ◽  
Vol 8 (10) ◽  
pp. 1612 ◽  
Author(s):  
Tsai ◽  
Gamper ◽  
Huang ◽  
Lee ◽  
Chang
Keyword(s):  
Emergency Department ◽  
Chest Pain ◽  
Clinical Symptoms ◽  
Thoracoscopic Surgery ◽  
Postoperative Mortality ◽  
Empyema Thoracis ◽  
Video Assisted ◽  
Group I ◽  
Laboratory Examinations ◽  
Video Assisted Thoracoscopic Surgery

Background: Video-assisted thoracoscopic surgery (VATS) is widely used for the treatment of empyema. We evaluated clinical symptoms, laboratory examinations, and thoracentesis to assess patients in the emergency department (ED) with empyema thoracis, undergoing VATS to identify predictors of adverse outcomes. Methods: This retrospective study was conducted by reviewing records of ED patients with pleural empyema admitted for VATS from January 2007 to June 2014. Demographic data, clinical symptoms, and laboratory examinations were compared for survivors (Group I) and non-survivors (Group II). Logistic regression analysis was used to identify parameters related to postoperative mortality. Results: From 380 patients, 7.6% (n = 29) died postoperatively. Survivors and non-survivors exhibited differences in age, gender, presence of cough, dyspnea, chest pain, empyema stage, cerebrovascular disease, malignancy, the glucose level of pleural fluid, serum hemoglobin, platelet count, blood urea nitrogen, and potassium levels. The logistic analysis demonstrated that the most significant factor related to the postoperative morbidity is chest pain (p = 0.018). Conclusions: VATS could be a safe option for pediatric and geriatric patients. Age does not appear to affect postoperative mortality. A high degree of awareness is essential for perioperative management and early surgical treatment when ED patients present with the clinical symptom of chest pain.

scholarly journals Video-assisted thoracoscopic surgery or transsternal thymectomy in the treatment of myasthenia gravis?

2010 ◽  
Vol 12 (1) ◽  
pp. 40-46 ◽  
Author(s):  
I. Zahid ◽  
S. Sharif ◽  
T. Routledge ◽  
M. Scarci
Keyword(s):  
Myasthenia Gravis ◽  
Thoracoscopic Surgery ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease

2021 ◽  
Vol 37 (4) ◽  
Author(s):  
Hao Zhang ◽  
Mei-ying Wang ◽  
Yong-nan Teng ◽  
Xiao-dan Wang ◽  
Hai-tao Cao
Keyword(s):  
Single Dose ◽  
Kawasaki Disease ◽  
Low Dose ◽  
Clinical Effect ◽  
Pulse Therapy ◽  
Inflammatory Factors ◽  
Control Group ◽  
High Dose ◽  
Experimental Group ◽  
Dose Prednisone

Objective: To evaluate the clinical effect of high-dose intravenous immunoglobulin (HDIVIG) single dose and pulse therapy combined with small-dose prednisone acetate in the treatment of patients with Kawasaki disease (KD). Methods: Eighty patients with KD from Baoding Children’s Hospital, China, were randomly divided into two groups: the experimental group and the control group, each with 40 cases. Patients in the experimental group were treated with HDIVIG single dose, pulse therapy combined with low-dose prednisone acetate, while patients in the control group were treated with conventional-dose immunoglobulin. Patients in both groups were treated with aspirin orally, and given symptomatic treatment including anti-inflammatory, nutritional support, correction of water and electrolyte disturbance and acid-base balance. Peripheral venous blood samples were drawn from all patients at the time of admission, Day-1, Day-7 and Day-14 after treatment, and in the basic state of getting up in the morning, and then the levels of tumor necrosis factor (TNF-a), C-reactive protein (CRP), interleukin-6 (IL-6) and other inflammatory factors were detected by enzyme-linked immunosorbent assay (ELISA). The time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, mucosal hyperemia regression after treatment in the two groups was recorded, and the treatment effect of the two groups was comprehensively evaluated. Results: After treatment, the levels of inflammatory factors such as TNF-a, CRP, IL-6 in the experimental group were significantly lower than those in the control group, with a statistically significant difference (P<0.05). In addition, the time of body temperature falling to normal, lymph node swelling recovery, hands and feet swelling, and mucosal hyperemia regression in the experimental group was significantly shorter than that in the control group (p=0.00). The effective rate of the experimental group was 95% and that of the control group was 80%, with a statistically significant difference (p=0.04). Conclusion: HDIVIG single dose, pulse therapy combined with small-dose prednisone acetate has a favourable therapeutic effect in the treatment of patients with KD, by which the inflammatory factors can be significantly improved, clinical symptoms and weight can be quickly ameliorated, and therapeutic effect can be enhanced. doi: https://doi.org/10.12669/pjms.37.4.4023 How to cite this:Zhang H, Wang MY, Teng YN, Wang XD, Cao HT. Observation on the clinical effect of high-dose Intravenous Immunoglobulin combined with low-dose prednisone acetate in the treatment of patients with Kawasaki Disease. Pak J Med Sci. 2021;37(4):---------. doi: https://doi.org/10.12669/pjms.37.4.4023 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Comparison of Subxiphoid and Intercostal Uniportal Thoracoscopic Thymectomy for Nonmyasthenic Early-Stage Thymoma: A Retrospective Single-Center Propensity-Score Matching Analysis

2020 ◽  
Author(s):  
Zhengcheng Liu ◽  
Rusong Yang
Keyword(s):  
Propensity Score ◽  
Propensity Score Matching ◽  
Early Stage ◽  
Thoracoscopic Surgery ◽  
Disease Stage ◽  
Perioperative Outcomes ◽  
Control Group ◽  
Video Assisted ◽  
Drainage Time ◽  
Video Assisted Thoracoscopic Surgery

Abstract Objective The aim of this study was to compare early outcome between intercostal uniportal video-assisted thoracoscopic surgery (IU-VATS) versus subxiphoid uniportal video-assisted thoracoscopic surgery (SU-VATS) in thymectomy for non-myasthenic early-stage thymoma. Method Retrospective analysis of 76 cases completed in our hospital from May 2018 to September 2019 with subxiphoid uniportal thoracoscopic thymectomy; a single incision of ∼3 cm was made ∼1 cm under the xiphoid process. The control group included 213 patients who received intercostal uniportal thoracoscopic thymectomy from August 2015, and propensity score matching was conducted. All patients who were clinically diagnosed with thymic tumor before surgery were treated with thymectomy. Perioperative outcomes between SU-VATS (n = 76) and IU-VATS, n = 76 were compared. Result After propensity score matching, there were no statistically significant differences between the two groups in terms of age, gender, disease stage, maximal tumor size, or other baseline demographic and clinical variables. All operation was successfully completed; there were no significant differences in the operative time (88 vs. 81 minutes, p = 0.63), intraoperative blood loss (55 vs. 46 mL, p = 0.47), postoperative drainage time (2.2 vs. 2.5 days, p = 0.72), and postoperative hospital stay (3.2 vs. 3.4 days, p = 0.78) between the two groups. The visual analog scale (VAS) on postoperative days 1, 3, 7, and 30 was less in the SU-VATS group than that in the IU-VATS group. The VAS on days 60 and 180 did not differ significantly between the two groups. Conclusion Thymectomy using SU-VATS is a feasible procedure; it might reduce early postoperative pain and lead to faster recovery.

Efficacy of Perioperative Administration of Intravenous Parecoxib on Postoperative Morphine Consumption after Video-Assisted Thoracoscopic Surgery

2021 ◽  
Vol 104 (11) ◽  
pp. 1836-1842
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Rating Scale ◽  
Thoracoscopic Surgery ◽  
Morphine Consumption ◽  
High Dose ◽  
Video Assisted ◽  
Significant Difference ◽  
Postoperative Morphine ◽  
Video Assisted Thoracoscopic Surgery

Background: Morphine is commonly used to relief pain after video-assisted thoracoscopic surgery (VATS), however high dose morphine is usually related with many complications. Parecoxib is a potent cyclo-oxygenase inhibitor for parenteral administration that has a role in acute pain management addition to opioid protocol. Objective: To investigate the potential benefits of intravenous parecoxib for relieving postoperative pain after VATS. Materials and Methods: The present study was a randomized controlled trial that assigned 22 patients undergoing VATS into two groups to received either parecoxib 40 mg as P group with 11 patients, or placebo using 2 mL of Normal Saline Solution as C group with 11 patients with an intravenous administration at 30 minutes prior to surgery and then 12 hours later. In the postoperative period, all patients received intravenous patient-controlled analgesia (PCA) with morphine. The primary outcome was the total morphine consumption for 24 hours postoperatively. The secondary outcomes were pain score at 2, 6, 12, and 24 hours postoperatively, using a numeric rating scale (NRS, 0 to 10) and the incidence of side effects. Results: The total morphine consumption was significantly lower in P group (26.64±4.41 mg) than C group (39.82±3.87 mg) at 24 hours postoperatively (p<0.001). The NRS pain score at rest and on coughing at 24 hours postoperatively between P group compared with C group were 1.09±1.04 versus 4.45±0.69 (p<0.001) and 2.91±0.83 versus 5.36±0.81 (p<0.001), respectively. The incidences of nausea and vomiting were found in both groups at 2, 6, and 12 hours, postoperatively, but there was no statistically significant difference between both groups (p>0.05). Other adverse events such as sedation, pruritus, dyspepsia, headache, hypotension, and respiratory depression were not found. Conclusion: Perioperative administration of parecoxib was safe and effectively decrease postoperative morphine consumption and pain score at rest and on coughing within 24 hours postoperatively after VATS. Keywords: Intravenous parecoxib; Video-assisted thoracoscopic surgery; Acute postoperative pain

Video-assisted thoracoscopic thymectomy for thymoma: a single-center experience

2018 ◽  
Vol 26 (3) ◽  
pp. 207-211 ◽  
Author(s):  
Giang Truong Nguyen ◽  
Trung Ngoc Nguyen ◽  
Nam Van Nguyen ◽  
Kien Trung Nguyen ◽  
Anh Viet Le
Keyword(s):  
Myasthenia Gravis ◽  
Operative Time ◽  
Thoracoscopic Surgery ◽  
Military Hospital ◽  
Video Assisted ◽  
Single Center Experience ◽  
Early Results ◽  
The Mean ◽  
Video Assisted Thoracoscopic Surgery

Background Thymoma is a primary tumor derived from the epithelial cells of the thymus, which is commonly seen in the mediastinum. Surgical thymectomy is the radical treatment for thymoma. The recent introduction of video-assisted thoracoscopic surgery has improved the quality of thymectomy surgery. The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. The objectives of this study were to investigate the clinical and laboratory characteristics of thymoma and to evaluate the early results of video-assisted thoracoscopic thymectomy for thymoma in Vietnamese patients. Methods All 53 thymoma patients with or without myasthenia gravis who underwent video-assisted thoracoscopic thymectomy in Military Hospital 103, Vietnam, from October 2013 to July 2017 were included. Results The mean age was 46.5 7.1 years, and the female/male ratio was 1.2:1. Myasthenia gravis, mostly stage IIA, was present in 84.9% of patients. There was no hospital mortality or major postoperative complication. The mean operative time was 65 min, intensive care unit stay was 22 ± 5 h, and postoperative hospital stay was 7.5 ± 1.7 days. Conclusion Thoracoscopic thymectomy for thymoma in Vietnamese patients achieved improved cosmesis and was safe for both non-myasthenia gravis and myasthenia gravis patients.

Minimally invasive rib-sparing video-assisted thoracoscopic surgery resections with high-dose-rate intraoperative brachytherapy for selected chest wall tumors

2016 ◽  
Vol 6 (6) ◽  
pp. e329-e335 ◽  
Author(s):  
Daniel J. Bourgeois ◽  
Sai Yendamuri ◽  
Mark Hennon ◽  
Jorge Gomez ◽  
Harish Malhotra ◽  
...  
Keyword(s):  
Minimally Invasive ◽  
Dose Rate ◽  
Chest Wall ◽  
Thoracoscopic Surgery ◽  
High Dose Rate ◽  
High Dose ◽  
Chest Wall Tumors ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery

scholarly journals F-018EFFECT OF HIGH-DOSE PREOPERATIVE METHYLPREDNISOLONE IN VIDEO-ASSISTED THORACOSCOPIC SURGERY LOBECTOMY: A DOUBLE BLIND, RANDOMIZED CONTROLLED TRIAL

2017 ◽  
Vol 25 (suppl_1) ◽  
Author(s):  
L S Bjerrgaard ◽  
P F Jensen ◽  
D R Bigler ◽  
René Horsleben Petersen ◽  
H M Sørensen ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Thoracoscopic Surgery ◽  
Controlled Trial ◽  
High Dose ◽  
Double Blind ◽  
Randomized Controlled ◽  
Video Assisted ◽  
Video Assisted Thoracoscopic Surgery
Sign in / Sign up

Export Citation Format

Share Document