https://scholars.lib.ntu.edu.tw/handle/123456789/584368
標題: | Thymectomy for non-thymomatous myasthenia gravis: a comparison of surgical methods and analysis of prognostic factors | 作者: | MONG-WEI LIN YIH-LEONG CHANG PEI-MING HUANG Lee Y.-C. |
公開日期: | 2010 | 卷: | 37 | 期: | 1 | 起(迄)頁: | 7-12 | 來源出版物: | European Journal of Cardio-thoracic Surgery | 摘要: | Objective: While thymectomy is an accepted treatment for myasthenia gravis (MG), video-assisted thoracoscopic surgery (VATS) thymectomy has recently become a popular surgical treatment, especially for non-thymomatous MG (NTMG). This study aims to compare the results of VATS thymectomy and trans-sternal thymectomy, and identify prognostic factors in NTMG patients after thymectomy. Methods: A 10-year retrospective review (January 1995 to December 2004) of 60 consecutive thymectomies (22 trans-sternal thymectomies and 38 VATS thymectomies) of NTMG patients performed in a university teaching hospital was undertaken. Results: There were 43 female patients and 17 male patients with a median MG-onset age of 25 years (range: 5-78 years). Median follow-up time was 44 months. VATS thymectomy patients had a shorter hospital stay than the trans-sternal thymectomy patients (5.6 days vs 8.1 days, p = 0.008). There was no other statistically significant difference between the two operative methods in NTMG patients, including intensive care unit (ICU) stay, ventilator support time, operative time, postoperative status, complete stable remission (CSR) rate, morbidity and mortality. Three prognostic factors associated with better remission rate were hyperthyroidism (p = 0.003), age <40 years (p = 0.022) and the presence of thymic hyperplasia (p = 0.041). Other factors, including gender, disease duration, preoperative MG severity, acetylcholine receptor antibody, perioperative therapy and operative methods (32% vs 36%, p = 0.91, 95% confidence interval (CI) = 0.27-3.21) were not statistically relevant to better remission rate. Conclusions: VATS thymectomy is more advantageous for NTMG patients because of shorter hospital stay, less tissue injury, better cosmetic result and equivalent CSR rate. NTMG patients aged <40 years with hyperthyroidism and a histologic diagnosis of lymphofollicular hyperplasia have better chances of remission after thymectomy. ? 2009 European Association for Cardio-Thoracic Surgery. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-72749109643&doi=10.1016%2fj.ejcts.2009.05.027&partnerID=40&md5=474450d98db74574cd4e50b7f0cf12fc https://scholars.lib.ntu.edu.tw/handle/123456789/584368 |
ISSN: | 1010-7940 | DOI: | 10.1016/j.ejcts.2009.05.027 | SDG/關鍵字: | cholinergic receptor antibody; adolescent; adult; aged; article; child; controlled study; disease duration; female; follow up; gender; hospitalization; human; hyperthyroidism; intensive care unit; major clinical study; male; myasthenia gravis; operation duration; postoperative care; priority journal; prognosis; remission; surgical technique; thoracoscopy; thorax surgery; thymectomy; thymus hyperplasia; video assisted thoracoscopic surgery; Adolescent; Adult; Age Factors; Age of Onset; Aged; Child; Child, Preschool; Epidemiologic Methods; Female; Humans; Length of Stay; Male; Middle Aged; Myasthenia Gravis; Prognosis; Remission Induction; Sternum; Thoracic Surgery, Video-Assisted; Thymectomy; Treatment Outcome; Young Adult |
顯示於: | 醫學系 |
在 IR 系統中的文件,除了特別指名其著作權條款之外,均受到著作權保護,並且保留所有的權利。