J Bramis, E Pikoulis, A Leppäniemi, E Felekouras, D Alexiou, E Bastounis
{"title":"重症肌无力患者早期胸腺切除术的益处。","authors":"J Bramis, E Pikoulis, A Leppäniemi, E Felekouras, D Alexiou, E Bastounis","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To report our experience of early thymectomy in patients with myasthenia gravis.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>University department of surgery, Greece.</p><p><strong>Subjects: </strong>76 Patients with myasthenia gravis.</p><p><strong>Interventions: </strong>Transcervical thymectomy in all cases, additional left thoracotomy in four cases.</p><p><strong>Main outcome measures: </strong>Mortality, morbidity, and early (6 months) and late (mean follow-up 4.8 years) response to thymectomy.</p><p><strong>Results: </strong>20 Patients had thymomas (26%). There was no postoperative mortality; morbidity was 11% (n = 8). There was complete remission in 19 (25%), improvement in 49 (65%) no change in 7 (9%), and impairment in 1 (1%) of the patients at 6 months. Patients who had had symptoms for less than 5 years (p < 0.001), were in an earlier stage of disease (p = 0.006), and who did not have thymomas (p = 0.006) responded better. 3 Patients died of invasive thymoma at 2 1/2, 3, and 5 1/2 years postoperatively and 25/76 (33%) were lost to follow-up. Of the 51 patients available for late follow-up, 19 (37%) were in remission, in 26 (51%) the symptoms had improved, 3 (6%) were unchanged, and 3 (6%) had died of the disease.</p><p><strong>Conclusions: </strong>Transcervical thymectomy should be considered in patients with early myasthenia gravis.</p>","PeriodicalId":22411,"journal":{"name":"The European journal of surgery = Acta chirurgica","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"1997-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Benefits of early thymectomy in patients with myasthenia gravis.\",\"authors\":\"J Bramis, E Pikoulis, A Leppäniemi, E Felekouras, D Alexiou, E Bastounis\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To report our experience of early thymectomy in patients with myasthenia gravis.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Setting: </strong>University department of surgery, Greece.</p><p><strong>Subjects: </strong>76 Patients with myasthenia gravis.</p><p><strong>Interventions: </strong>Transcervical thymectomy in all cases, additional left thoracotomy in four cases.</p><p><strong>Main outcome measures: </strong>Mortality, morbidity, and early (6 months) and late (mean follow-up 4.8 years) response to thymectomy.</p><p><strong>Results: </strong>20 Patients had thymomas (26%). There was no postoperative mortality; morbidity was 11% (n = 8). There was complete remission in 19 (25%), improvement in 49 (65%) no change in 7 (9%), and impairment in 1 (1%) of the patients at 6 months. Patients who had had symptoms for less than 5 years (p < 0.001), were in an earlier stage of disease (p = 0.006), and who did not have thymomas (p = 0.006) responded better. 3 Patients died of invasive thymoma at 2 1/2, 3, and 5 1/2 years postoperatively and 25/76 (33%) were lost to follow-up. Of the 51 patients available for late follow-up, 19 (37%) were in remission, in 26 (51%) the symptoms had improved, 3 (6%) were unchanged, and 3 (6%) had died of the disease.</p><p><strong>Conclusions: </strong>Transcervical thymectomy should be considered in patients with early myasthenia gravis.</p>\",\"PeriodicalId\":22411,\"journal\":{\"name\":\"The European journal of surgery = Acta chirurgica\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"1997-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"The European journal of surgery = Acta chirurgica\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"The European journal of surgery = Acta chirurgica","FirstCategoryId":"1085","ListUrlMain":"","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Benefits of early thymectomy in patients with myasthenia gravis.
Objective: To report our experience of early thymectomy in patients with myasthenia gravis.
Design: Retrospective study.
Setting: University department of surgery, Greece.
Subjects: 76 Patients with myasthenia gravis.
Interventions: Transcervical thymectomy in all cases, additional left thoracotomy in four cases.
Main outcome measures: Mortality, morbidity, and early (6 months) and late (mean follow-up 4.8 years) response to thymectomy.
Results: 20 Patients had thymomas (26%). There was no postoperative mortality; morbidity was 11% (n = 8). There was complete remission in 19 (25%), improvement in 49 (65%) no change in 7 (9%), and impairment in 1 (1%) of the patients at 6 months. Patients who had had symptoms for less than 5 years (p < 0.001), were in an earlier stage of disease (p = 0.006), and who did not have thymomas (p = 0.006) responded better. 3 Patients died of invasive thymoma at 2 1/2, 3, and 5 1/2 years postoperatively and 25/76 (33%) were lost to follow-up. Of the 51 patients available for late follow-up, 19 (37%) were in remission, in 26 (51%) the symptoms had improved, 3 (6%) were unchanged, and 3 (6%) had died of the disease.
Conclusions: Transcervical thymectomy should be considered in patients with early myasthenia gravis.