scholarly journals Examination on the necessity of pericardial fat tissue resection in extended thymectomy for myasthenia gravis

Gland Surgery ◽  
2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
Katsuhiro Okuda ◽  
Hideo Hattori ◽  
Keisuke Yokota ◽  
Tsutomu Tatematsu ◽  
Tadashi Sakane ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Fat Tissue ◽  
Extended Thymectomy ◽  
Pericardial Fat

scholarly journals Evaluation of extended thymectomy approaches based on residual fat tissue

2020 ◽  
Author(s):  
Mitsuteru Yoshida ◽  
Masao Yuasa ◽  
Kazuya Kondo ◽  
Mitsuhiro Tsuboi ◽  
Naoya Kawakita ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Myasthenia Gravis ◽  
Three Dimensional ◽  
Median Sternotomy ◽  
Operation Time ◽  
Anterior Mediastinum ◽  
Fat Tissue ◽  
Extended Thymectomy ◽  
Residual Rate ◽  
Advantages And Disadvantages

Abstract OBJECTIVES This study analysed the patterns of extraction ranges, characteristics, advantages and disadvantages of median sternotomy (MS) and subxiphoid (SX) approaches for extended thymectomy. METHODS This study included patients with anterior mediastinum tumour and myasthenia gravis who underwent extended thymectomy at our institution between 2015 and 2018. There were 5 MS and 6 SX extended thymectomy surgeries with the VINCENT software. On preoperative computed tomography, the thymus area and fat tissue surrounding the thymus, which were planned for extraction, were traced using VINCENT (Ver. 4.0). We then constructed three-dimensional images and calculated the volumes. Evaluation of the extended thymectomy approach based on the residual fat tissue was required to determine the area of extended thymectomy. RESULTS No significant differences in operation time (min) [SX: 197.3 ± 34.0, MS: 206.6 ± 91.4, drainage duration (days), SX: 2.2 ± 1.0, MS: 2.2 ± 0.4, hospital stay (days), SX: 11.8 ± 1.2, MS: 13.4 ± 2.1, residual rate (%), SX: 29.9 ± 17.5, MS: 58.7 ± 18.0 (P = 0.0519)] were observed between the 2 groups. Bleeding was significantly lower for SX than for MS. The residual rate was lower for SX than for MS. CONCLUSIONS Considering the amount of the residual fat tissue, the SX approach allows an adequate dissection area for extended thymectomy compared with the MS approach.

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 Predictive factors of myasthenic crisis after extended thymectomy for patients with myasthenia gravis

2015 ◽  
Vol 48 (5) ◽  
pp. 705-709 ◽  
Author(s):  
Takeshi Ando ◽  
Mitsugu Omasa ◽  
Takayuki Kondo ◽  
Tetsu Yamada ◽  
Masaaki Sato ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Predictive Factors ◽  
Myasthenic Crisis ◽  
Extended Thymectomy

scholarly journals Thymoma resection in a patient with a history of extended thymectomy for myasthenia gravis without thymoma

2016 ◽  
Vol 30 (2) ◽  
pp. 214-217
Author(s):  
Yasuhiro Otsuki ◽  
Kotaro Kameyama ◽  
Tomoaki Matsuoka ◽  
Kenji Kimura ◽  
Norihito Okumura
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
History Of

Thymoma Associated with Pure Red-Cell Aplasia: Clinical Features and Prognosis

2002 ◽  
Vol 10 (2) ◽  
pp. 150-154 ◽  
Author(s):  
Tomohiro Murakawa ◽  
Jun Nakajima ◽  
Hajime Sato ◽  
Makoto Tanaka ◽  
Shinichi Takamoto ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Features ◽  
Surgical Intervention ◽  
Pure Red Cell Aplasia ◽  
The Other ◽  
Entire Group ◽  
Red Cell ◽  
Extended Thymectomy ◽  
Red Cell Aplasia

As information on the clinical features and prognosis of thymoma complicated by pure red-cell aplasia is limited, follow-up data on thymoma patients who had a thymectomy between 1954 and 1999 were analyzed retrospectively. Six of 166 cases were complicated by pure red-cell aplasia. In 3 of these, the pure red-cell aplasia appeared after surgical intervention. Remission was observed in 2 patients who underwent extended thymectomy. The other 4 patients subsequently died from pure red-cell aplasia. The outcome in patients with pure red-cell aplasia was poorer than that in the entire group of patients with thymoma and in those with thymoma complicated by myasthenia gravis. The possible onset of pure red-cell aplasia after thymectomy should be kept in mind during follow-up.

Long-term evaluation of extended thymectomy with anterior mediastinal dissection for myasthenia gravis

Surgery ◽  
2001 ◽  
Vol 130 (4) ◽  
pp. 774-780 ◽  
Author(s):  
Lawrence E. Stern ◽  
Michael S. Nussbaum ◽  
John G. Quinlan ◽  
Josef E. Fischer
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Mediastinal Dissection ◽  
Term Evaluation

Video-assisted thoracoscopic extended thymectomy and extended transsternal thymectomy (T-3b) in non-thymomatous myasthenia gravis patients: remission after 6 years of follow-up

2003 ◽  
Vol 212 (1-2) ◽  
pp. 31-36 ◽  
Author(s):  
Renato Mantegazza ◽  
Fulvio Baggi ◽  
Pia Bernasconi ◽  
Carlo Antozzi ◽  
Paolo Confalonieri ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy ◽  
Video Assisted

First experience of robotic extended thymectomy in Japan for myasthenia gravis with thymoma

2012 ◽  
Vol 60 (3) ◽  
pp. 183-187 ◽  
Author(s):  
Hiroshige Nakamura ◽  
Yuji Taniguchi ◽  
Shinji Fujioka ◽  
Ken Miwa ◽  
Tomohiro Haruki ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Extended Thymectomy

A propensity score analysis for comparison of T-3b and VATET in myasthenia gravis

Neurology ◽  
2017 ◽  
Vol 89 (2) ◽  
pp. 189-195 ◽  
Author(s):  
Greta Brenna ◽  
Carlo Antozzi ◽  
Cristina Montomoli ◽  
Fulvio Baggi ◽  
Renato Mantegazza ◽  
...  
Keyword(s):  
Propensity Score ◽  
Myasthenia Gravis ◽  
Clinical Data ◽  
Propensity Score Analysis ◽  
Statistical Tests ◽  
Surgical Approaches ◽  
Extended Thymectomy ◽  
Score Analysis ◽  
Complete Set

Objective:We performed propensity score (PS) models to compare the outcome of patients with myasthenia gravis (MG) submitted to 2 different surgical approaches: extended transsternal (T-3b) or thoracoscopic extended thymectomy (VATET).Methods:Patients' clinical data were retrieved from the MG database of the C. Besta Neurologic Institute Foundation. In the PS analysis, a matching ratio of 1:1 of the main clinical variables was obtained for the 2 groups of patients and treatment effect was estimated by comparing their outcome.Results:A total of 210 patients met the inclusion criteria, by having a complete set of clinical data, and were included in the PS model; a matched dataset of 122 participants (61 per group) showed an adequate balance of all the covariates. Our analysis demonstrated that 68.9% of patients who had thymectomy by the VATET technique reached the pharmacologic remission/remission status at 2 years from thymectomy compared to 34.4% of those operated on by the T-3b technique (p < 0.001), had a lower INCB-MG score (p < 0.001), and had less muscle fatigability (p = 0.004). Similar results were found considering only nonthymomatous patients with MG. Results were also confirmed by paired statistical tests.Conclusions:Our PS matching analysis showed that VATET is a reliable and effective surgical approach alternative to T-3b in patients with MG who are candidates for thymectomy.Classification of evidence:This study provides Class IV evidence that for patients with MG, VATET is more effective than T-3b thymectomy.

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