2006, Number 4
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Rev Inst Nal Enf Resp Mex 2006; 19 (4)
Results of maximal thymectomy in myasthenia gravis. A 20 year experience at The Pulmonology and Thoracic Surgery Department of Mexico’s General Hospital. The influence of thymectomy over the dose of pyridostigmine and three spirometric variables in myasth
Navarro-Reynoso F, Pérez-Romo A, Green L, Páramo-Arroyo R, Cicero-Sabido R
Language: Spanish
References: 30
Page: 252-257
PDF size: 80.78 Kb.
ABSTRACT
Myasthenia gravis (MG) is a disease of the neuromuscular plaque characterized by weakness and fatigue. It can be related to thymic tumors or hyperplasia of the gland. MG is treated with pyridostigmine; if medical control can not be achieved or unpleasant symptoms appear, thymectomy is indicated. We present our 20 year experience with 126 cases of transternal maximal thymectomy for the treatment of MG; there were two postoperative deaths related to respiratory muscle weakness. Statistically significant improvements in pyridostigmine dosage, tidal volume, vital capacity and maximal inspiratory force were seen after surgery.
REFERENCES
Davis RD Jr, Oldham HN Jr, Sabiston DC Jr. The mediastinum. In: Sabiston DC, Spencer FC, editors. Surgery of the chest. 5a ed. New York: Saunders; 1990. p. 498-535.
Kim LH, Sabiston DC Jr. Neoplasias y quistes primarios del mediastino. En: Fishman A, editor. 2a ed. Tratado de neumología. México: McGraw-Hill; 1983. p. 1938-1962.
Adams RD, Victor M. Principles of neurology. 5th ed. New York: McGraw-Hill; 1993. p. 1252-1270.
Drachman DB. Myasthenia gravis. N Engl J Med 1994;330:1797-1810.
Marchevsky AM, Kaneko M. Surgical pathology of the mediastinum. New York: Raven Press;1984.
Osserman KE, Genkins G. Studies on myasthenia gravis; a reference for health care professionals. In: Myasthenia Gravis Foundation of America. HYPERLINK http://www.myasthenia.org November, 2003.
Navarro RF, Pérez-Romo A, Escosura-Romero G, Lorenzo-Silva JM, Cicero-Sabido R. Timectomía y miastenia gravis. Rev Inst Nal Enf Resp Mex 1997;10:286-293.
Navarro RF, Lorenzo SJ. Tratamiento de los tumores gigantes del mediastino. Gac Med Mex 2001;137:117-124.
Slater G, Papatestas AE, Genkins G, Kornfeld P, Horowitz SH, Bender A. Thymomas in patients with myasthenia gravis. Ann Surg 1978;188:171-174.
Jaretzki A, Wolff M. “Maximal” thymectomy for myasthenia gravis. Surgical anatomy and operative technique. J Thorac Cardiovasc Surg 1988;96:711-716.
Gibbon’s F. Cirugía del mediastino. En: Gibbon´s F, editor. Cirugía de tórax. Barcelona: Salvat;1983. p. 250-278.
Blalock A, Mason MF, Morgon HJ, Riven SS. Myasthenia gravis and tumors of the thymic region: report of a case in which the tumor was removed. Ann Surg 1939;110:544-561.
Genkins G, Papatestas AE, Horowitz SH, Kornfield P. Studies in myasthenia gravis: early thymectomy. Electrophysiologic and pathologic correlations. Am J Med 1975;58:517-524.
Hatton PD, Diehl JT, Daly BD, et al. Trans-sternal radical thymectomy for myasthenia gravis: a 15-year review. Ann Thorac Surg 1989;47:838-840.
Hatcher CR Jr, Abbott OA, Logan WD Jr, Symbas PN. Current status of thymectomy for myasthenia gravis. Ann Thorac Surg 1967;3:132-135.
Mulder DG, Graves M, Herrmann C. Thymectomy for myasthenia gravis: recent observations and comparisons with past experience. Ann Thorac Surg 1989;48:551-555.
Mulder DG, Herrmann C Jr, Keesey J, Edwards H. Thymectomy for myasthenia gravis. Am J Surg 1983;146:61-66.
Kirschner PA. Myasthenia gravis. In: Roth JA, Ruckdeschel JC, Weisenburger TH, editors. Thoracic oncology. New York: McGraw-Hill; 1989. p. 237-259.
Huang MH, King KL, Hsu WH, et al. The outcome of thymectomy in nonthymomatous myasthenia gravis. Surg Gynecol Obstet 1988;166:436-440.
Dau PC, Lindstrom JM, Cassel CK, Denys EH, Shev EE, Spitler LE. Plasmapheresis and immunosuppressive drug therapy in myasthenia gravis. N Engl J Med 1977;297:1134-1140.
Perlo VP, Arnason B, Castleman B. The thymus gland in elderly patients with myasthenia gravis. Neurology 1975;25:294-295.
Lindberg C, Andersen O, Larsson S, Oden A. Remission rate after thymectomy in myasthenia gravis when the bias of immunosuppressive therapy is eliminated. Acta Neurol Scand 1992;86:323-328.
Scadding GK, Havard CW, Lange MJ, Domb I. The long term experience of thymectomy for myasthenia gravis. J Neurol Neurosurg Psychiatry 1985;48:401-406.
Nussbaum MS, Rosenthal GJ, Samaha FJ, et al. Management of myasthenia gravis by extended thymectomy with anterior mediastinal dissection. Surgery 1992;112:681-687.
Sanders DB, editor. Neurologic clinics. Myasthenia gravis and myasthenic syndromes. Philadelphia: Saunders;1994. p. 120-122.
Batra P, Herrmann C Jr, Mulder D. Mediastinal imaging in myasthenia gravis: correlation of chest radiography, CT, MR, and surgical findings. AJR 1987;148:515-519.
Vincent A, Palace J, Hilton-Jones D. Myasthenia gravis. Lancet 2001;357:2122-2128.
Reyes ERE, Olivares MH. Espirítu MS. Manejo anestésico del paciente con miastenia gravis. An Med Asoc Med Hosp ABC 2003;48:156-161.
Jaretzki A, Baroh RJ, Ernstoff RM, et al. Myasthenia gravis: recommendations for clinical research standards. Task Force of the Medical Scientific Advisory Board of the Myasthenia Gravis Foundation of America. Neurology 2000;55:16-23.
Weder-Cisneros N, Téllez-Zenteno JF, Velásquez-Paz A, et al. Respuesta de la timectomía en pacientes con timoma y miastenia gravis. Rev Invest Clin 2003;55:629-634.