Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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Extended thymectomy through video assisted thoracic surgery and cervicotomy in the treatment of myasthenia

Timectomia estendida por cirurgia torácica videoassistida e cervicotomia no tratamento da miastenia

Eduardo Haruo Saito, Cláudio Higa, Rodolfo Acatauassu Nunes, Gérson C. Magalhães, Luiz Carlos Aguiar Vaz, Vicente Faria Cervante

J Bras Pneumol.2003;29(5):273-279

Abstract PDF PT

Background: The relationship between myasthenia and the thymus is evident and the current treatment of this condition includes thymectomy. However, a revision of our experience with thymectomy has revealed the necessity of a more radical technique. Objective: To analyze, retrospectively, myasthenia gravis patients who underwent videothoracoscopic radical thymectomy, emphasizing the advantages and drawbacks of the methodology, pathological findings and results related to disease control. Material and methods: Twenty-one myasthenic patients (18 females and 3 males, aged 17 to 51 years), underwent videothoracoscopic bilateral thymectomy associated to transverse cervicotomy for removal of the thymus gland and surrounding tissues, and right and left pericardiac fat tissues. Those tissues were separately sent to pathology analysis. The mean time of follow-up was 39.2 months. Results: There were no intra-operative deaths. Two patients (9.5%) suffered vascular injury, and one patient (4.8%) presented a low level permanent dysphonia. Nineteen patients (90.4%) are doing well, with none or low dose medications. Pathology studies showed 10 hyperplastic thymuses, 6 with involution and 5 with normal aspect. Ectopic thymic tissue was found in six patients (28.6%). Conclusion: Videothoracoscopic radical thymectomy offered a good control of myasthenia gravis. Additionally, ectopic thymus tissue was removed from some patients.

 


Keywords: Thorax. Surgery, video-assisted. Myastenia gravis. Thymectomy.

 


 

 


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