OBJECTIVE: To study the impact of minimally invasive trans-cervical thymectomy on the incidence of remission of patients with myasthenia gravis (MG) in a single institution over a 10-year period. METHODS: A total of 120 consecutive patients referred for video-assisted trans-cervical thymectomy between 1991 and 2000 were included in the analysis. Complete remission was defined as no symptoms and no treatment for 6 months, and remission as minimal ocular symptoms (slight ptosis) or treatment with pyridostigmine only for 6 months. RESULTS: There were 86 females and 34 males with a median age of 33 (range 14-79) and 36 years (range 12-68), respectively. Symptoms of MG lasted between 2 months and 17 years before thymectomy (median 10 months). Surgery was converted to a partial upper sternotomy in 23 cases (19%). The median hospital stay decreased from 2 days (range 1-8) before 1994 to 1 day (range 1-8) thereafter (p<0.0001). Postoperative complications occurred in four patients (3.3%). After a median follow-up of 48 months (range 6-117 months), 50% of the patients were in complete remission (41%) or in remission (9%). Kaplan-Meier estimates rate of complete remission were 30% after 5 years of follow-up and 91% after 10 years. CONCLUSIONS: Minimally invasive trans-cervical thymectomy can be performed with short hospital stay and low morbidity, and achieve excellent durable results at 10 years.
OBJECTIVE: To study the impact of minimally invasive trans-cervical thymectomy on the incidence of remission of patients with myasthenia gravis (MG) in a single institution over a 10-year period. METHODS: A total of 120 consecutive patients referred for video-assisted trans-cervical thymectomy between 1991 and 2000 were included in the analysis. Complete remission was defined as no symptoms and no treatment for 6 months, and remission as minimal ocular symptoms (slight ptosis) or treatment with pyridostigmine only for 6 months. RESULTS: There were 86 females and 34 males with a median age of 33 (range 14-79) and 36 years (range 12-68), respectively. Symptoms of MG lasted between 2 months and 17 years before thymectomy (median 10 months). Surgery was converted to a partial upper sternotomy in 23 cases (19%). The median hospital stay decreased from 2 days (range 1-8) before 1994 to 1 day (range 1-8) thereafter (p<0.0001). Postoperative complications occurred in four patients (3.3%). After a median follow-up of 48 months (range 6-117 months), 50% of the patients were in complete remission (41%) or in remission (9%). Kaplan-Meier estimates rate of complete remission were 30% after 5 years of follow-up and 91% after 10 years. CONCLUSIONS: Minimally invasive trans-cervical thymectomy can be performed with short hospital stay and low morbidity, and achieve excellent durable results at 10 years.
Authors: Fabrizio Minervini; Laura Boschetti; Michael Gregor; Mariano Provencio; Virginia Calvo; Peter B Kestenholz; Savvas Lampridis; Davide Patrini; Pietro Bertoglio; L Filipe Azenha; Consolato M Sergi; Gregor J Kocher Journal: Gland Surg Date: 2021-11
Authors: Marcin Zieliński; Mariusz Rybak; Katarzyna Solarczyk-Bombik; Michal Wilkojc; Wojciech Czajkowski; Sylweriusz Kosinski; Edward Fryzlewicz; Tomasz Nabialek; Malgorzata Szolkowska; Juliusz Pankowski Journal: J Vis Surg Date: 2017-11-17
Authors: Chang Young Lee; Jin Gu Lee; Woo Ik Yang; Suk Jin Haam; Kyung Young Chung; In Kyu Park Journal: Yonsei Med J Date: 2008-12-31 Impact factor: 2.759