Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
권호 표지

Maximal Thymectomy for Myasthenia Gravis Management

중증 근무력증치료를 위한 광범위흉선절제술의 효과

  • Published : 1995.09.01
Download PDF
⟨ Previous Next ⟩

Abstract

Thymectomy has played a central role in the management of myasthenia gravis. Although both the etiology of myasthenia gravis and the reason for improvement after thymectomy remain incompletely explained, complete removal of the thymus is the logical goal of surgical treatment for this disease.From April 1989 to June 1994, maximal thymectomy was performed for 19 cases of myasthenia gravis at Chonnam National University Hospital. The results were as follows:1.Among the 19 cases, male-to-female ratio was 1:1.4, the age ranged 13 years to 71 years, and a diphasic presentation appeared with a peak in young females and a second peak in elderly males;2.Five cases were classified by modified Osserman`s classification as Group I and Group IIa and 14 cases as Group IIb and Group IIc; 3.Histologic examination of the excised thymus glands revealed normality in 5 cases [26% , thymic hyperplasia in 4 [21% , benign thymoma in 8 [42% , and malignant thymoma in 2 [11% ;4.There was no operative mortalities but two deaths occurred during the follow-up periods due to myasthenic crisis and other causes;5.The clinical improvement and the complete remission rates were 85% and 32%, respectively;6.The clinical improvement and the complete remission rates were not so good in patients with thymomas, beeing 70% and 20%, respectively; and 7.Young women with hyperplasia of the thymic tissue tended to show the best response to thymectomy.

Keywords

References

  1. Ann. Thorac. Surg. v.43 Alfred Blalock and thymectomy for myasthenia gravis Kirschner,P.A.
  2. J. Thorac. Cardiovasc. Surg. v.95 Maximal thymectomy for myasthenia gravis;Results Jaretzki,A.;Penn,A.S.;Younger,D.S.(et al.)
  3. Glenn's Thoracic and Cardiovascular Surgey(5th ed.) The mediastinum Ewing,H.P.;Hardy,H.D.;Arthur,E.B.(ed.);Alexander,S.G.(ed.);Graeme,L.H.(ed.);Hillel,L.(ed.);Keith,S.N.(ed.)
  4. Lancet v.2 Remission of myasthenia gravis following plasma exchange Pinching,A.J.;Petes,D.K.;Newsom Davis,J.
  5. Neurology v.40 Indications for thymectomy in myasthenia gravis Lanska,D.J.
  6. J. Neurol. v.235 Thymectomy in the treatment of myasthenia gravis : report of 247 patients Evoli,A.;Batocchi,A.P.;Provenzano,C.;Ricci,E.;Tonali,P.
  7. Ann. Thorac. Surg. v.47 Transsternal redical thymectomy for myasthenia gravis : a 15year review Hatton,P.D.;Diehl,J.T.;Daly,B.D.T.(et al.)
  8. Ann. Surg. v.206 Effects of thymectomy in myasthenia gravis Papatestas,A.E.;Genkins,G.;Kornfeld,P.(et al.)
  9. Ann. Surg. v.201 Thymectomy for myasthenia gravis : 14-year exprience Hankins,J.R.;Mayer,R.F.;Satterfield,J.R.(et al.)
  10. J. Neurol. Neurosurg. Psych. v.48 Thymectomy in myasthenia with pure ocular symptoms Schumm,F.;Wietholter,H.;Fatch-Moghadam,A.;Dichgans,J.
  11. Neurology v.16 Myasthenia gravis : evaluation of treatment in 1,335 patients Perlo,V.P.;Poskanzer,D.C.;Schwab,R.S.;Viets,H.R.;Osserman,K.E.;Genkins,G.
  12. 대흉외지 v.21 중증근무력증의 외과적 치료 손영상;임창영;김광택;김형묵
  13. 대흉외지 v.23 중증근무력증의 외과적 요법 서필원;성숙환;김주현
  14. Ann NY Acad. Sci. v.505 Thymectomy as primary therapy in myasthenia gravis Olanow,C.W.;Wechsler,A.S.;Sirotkin-Roses,M.;Stajich,J.;Roses,A.D.
  15. Ann. Thorac Surg. v.48 Thymectomy for myasthenia gravis: recent observations and comparisons with past experience Mulder,D.G.;Graves,M.;Herrmann,C.