SciELO - Scientific Electronic Library Online

 
vol.146 número4Implicancias en la actividad física y la salud del Programa CicloRecreoVía en ChileSíntomas durante el sueño en pacientes con sospecha de Síndrome de Apnea e Hipopnea Obstruciva del sueño índice de autoresíndice de assuntospesquisa de artigos
Home Pagelista alfabética de periódicos  

Serviços Personalizados

Journal

Artigo

Indicadores

Links relacionados

  • Em processo de indexaçãoCitado por Google
  • Não possue artigos similaresSimilares em SciELO
  • Em processo de indexaçãoSimilares em Google

Compartilhar


Revista médica de Chile

versão impressa ISSN 0034-9887

Resumo

GONZALEZ L., Roberto et al. Results of extended transsternal thymectomy for Myasthenia gravis. Experience with 58 patients. Rev. méd. Chile [online]. 2018, vol.146, n.4, pp.460-469. ISSN 0034-9887.  http://dx.doi.org/10.4067/s0034-98872018000400460.

Background:

Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG).

Aim:

To describe the immediate and long-term results of extended transsternal thymectomy (ETT) in patients with MG.

Material and Methods:

A review of databases, surgical protocols, clinical records and interviews of patients subjected to extended transsternal thymectomy for MG between 1990 and 2016. Perioperative clinical characteristics, anticholinesterase treatment, immediate and remote surgical results were analyzed and patients were followed from one to 10years.

Results:

We studied 58 patients aged 35 ± 14years (72%) women. In the preoperative period, according to Osserman classification, nine patients (15,5%) were in grade I, eight (13,8%) in grade IIA 8 and 40 (69%) in grade IIB. The pathological study of the surgical piece showed thymic hyperplasia in 39 cases (67,2%). Four patients had postoperative complications but none died. In the Follow-up at 1, 3, 5, 8 and 10years the Masaoka palliation rate was 71.7, 77.5, 67.7, 70.0 and 70,6% respectively. The figures for remission rate were 13.0, 15.0,19.4, 35.0 and 35,3% respectively. The figures for Zielinski positive results were 79.6, 87.5, 87.1, 90.0 and 82,4% respectively. The DeFilippi score improved by 80.4, 87.5, 87.1, 90.0 and 82.4% respectively. The Myasthenia Gravis Foundation of America Post-Intervention State improved by 67.4, 77.5, 77.5, 75.0 and 70,6% respectively. Mean Myasthenia Gravis Activities of daily living (MGADL) and Myasthenia Gravis Quality of life scale 15 (MGQOL 15) were 1.65 and 6.31 respectively.

Conclusions:

In selected patients with MG, extended transsternal thymectomy in MG has good immediate and long-term results.

Palavras-chave : Myasthenia Gravis; Thoracic Surgery; Thymectomy; Thymus Hyperplasia.

        · texto em Espanhol     · Espanhol ( pdf )