Ministernotomy Thymectomy in Mysthania Gravis-Future

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Suraj Wasudeo Nagre*
K N Bhosle

Abstract

A thymectomy is the surgical removal of the thymus gland. The thymus has been demonstrated to play a role in the development of MG. It is removed in an effort to improve the weakness caused by MG, and to remove a thymoma if present.About 10% of MG patients have a tumor of the thymus called a thymoma. Most of these tumors are benign and tend to grow very slowly; on occasion they are malignant (“cancerous”).A thymectomy is recommended for patients under the age of 60 (occasionally older) with moderate to severe MG weakness. It is sometimes recommended for patients with relatively mild weakness, especially if there is weakness of the respiratory (breathing) or oropharyngeal (swallowing) muscles. It is also recommended for all patients with a thymoma. A thymectomy is usually not recommended for patients with weakness limited to the eye muscles (ocular myasthenia gravis). The neurological goals of a thymectomy are significant improvement in the patient’s weakness, reduction in the medications being employed, and ideally eventually a permanent remission (complete elimination of all weakness off all medications). There are three basic surgical approaches transternal, transcervical and videoscopic[VATS] thymectomy each with several variations. Regardless of the technique employed, the surgical goal is to remove the entire thymus. Many believe this should include removal of the adjacent fat; others are less sure.Here we give our study report of comparision between full sternotomy against ministernotomy thymectomy patients preopt, intraopt and postopt factors, fifteen patients each in two group with ten year experience

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Nagre, S. W., & Bhosle, K. N. (2017). Ministernotomy Thymectomy in Mysthania Gravis-Future. Journal of Cardiovascular Medicine and Cardiology, 4(4), 070–074. https://doi.org/10.17352/2455-2976.000053
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Copyright (c) 2017 Nagre SW, et al.

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Heitmiller RF (1999) Myasthenia gravis: clinical features, pathogenesis, evaluation, and medical management. Semin Thorac Cardiovasc Surg 11: 41–46. Link: https://goo.gl/ZwX7Zq

Drachman DB (1994) Myasthenia gravis. N Engl J Med 330: 1797–1810. Link: https://goo.gl/SGuKmR

Grob D, Arsura EL, Brunner NG, Namba T (1987) The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci 505: 472–499. Link: https://goo.gl/93MmeM

Papatestas AE, Genkins G, Kornfeld P, Eisenkraft JB, Fagerstrom RP, et al. (1987) Effects of thymectomy in myasthenia gravis. Ann Surg 206: 79–88. Link: https://goo.gl/eAiiC3

Kirschner PA, Osserman KE, Kark AE (1969) Studies in myasthenia gravis. Transcervical total thymectomy. JAMA 209: 906–910. Link: https://goo.gl/Wz9RnU

Mulder DG, Herrmann C, Buckberg GD (1974) Effect of thymectomy in patients with myasthenia gravis. A sixteen year experience. Am J Surg 128: 202–206. Link: https://goo.gl/L9fxZP

Detterbeck FC, Scott WW, Howard JF Jr, Egan TM, Keagy BA, et al. (1996) One hundred consecutive thymectomies for myasthenia gravis. Ann Thorac Surg 62: 242–245. Link: https://goo.gl/7BBwgp

Yim AP, Kay RL, Ho JK (1995) Video-assisted thoracoscopic thymectomy for myasthenia gravis. Chest 108: 1440–1443. Link: https://goo.gl/3um7ta

Mack MJ, Landreneau RJ, Yim AP, Hazelrigg SR, Scruggs GR (1996) Results of video-assisted thymectomy in patients with myasthenia gravis. J Thorac Cardiovasc Surg 112: 1352–1360. Link: https://goo.gl/miqwnu

Nagre SW (2016) Hurdles for Starting Ministernotomy Aortic Valve Replacement Program. J Cardiovasc Med Cardiol 3: 035-037. Link: https://goo.gl/ddfqdp

Osserman KE (1958) Myasthenia gravis. New York: Grune and Stratton Inc 79–86.

Blalock A, Manson MF, Morgan HJ, Riven SS (1939) Myasthenia gravis and tumors of the thymic region: report of a case in which the tumor was removed. Ann Surg 110: 544–561. Link: https://goo.gl/qqTyNV

Monden Y, Nakahara K, Fujii Y, Hashimoto J, Ohno K, et al. (1985) Myastenia gravis in elderly patients. Ann Thorac Surg 39:433–436. Link: https://goo.gl/uYfa53

Hamada Y, Sakai Y, Ito H, Ichikawa H, Morishita Y (1999) Extended thymectomy for myasthenia gravis in an octagenarian. A case report. J Cardiovasc Surg (Torino) 40: 893–895. Link: https://goo.gl/JsSYU2

Evoli A, Batocchi AP, Batocchi AP, Minisci C, Di Schino C, et al. (2000) Clinical characteristics and prognosis of myasthenia gravis in older people. J Am Geriatr Soc 48:1442–1448. Link: https://goo.gl/brcCsD

Hatton PD, Diehl JT, Daly BD, Rheinlander HF, Johnson H, et al. (1989) Transsternal radical thymectomy for myasthenia gravis: a 15-year review. Ann Thorac Surg 47: 838–840. Link: https://goo.gl/yxiRtq

Nieto IP, Robledo JP, Pajuelo MC, Montes JAR, Giron JG, et al. (1999) Prognostic factors for myasthenia gravis treated by thymectomy: review of 61 cases. Ann Thorac Surg 67: 1568–1571. Link: https://goo.gl/AxXvzU

Grandjean JG, Lucchi M, Mariani MA (2000) Reversed-T upper mini-sternotomy for extended thymectomy in myasthenic patients. Ann Thorac Surg 70: 1423–1424. Link: https://goo.gl/xD7j9i

Paletto AE, Maggi G (1982) Thymectomy in the treatment of myasthenia gravis: results in 320 patients. Int Surg 67: 13–16.

LoCicero J 3rd (1996) The combined cervical and partial sternotomy approach for thymectomy. Chest Surg Clin N Am 6: 85–93. Link: https://goo.gl/6YsKnW

Mineo TC, Pompeo E, Lerut TE, Bernardi G, Coosemans W, et al. (2000) Thoracoscopic thymectomy in autoimmune myasthenia: results of left-sided approach. Ann Thorac Surg 69: 1537–1541. Link: https://goo.gl/fKUmQB

Masaoka A, Yamakawa Y, Niwa H, Fukai I, Kondo S, et al. (1996) Extended thymectomy for myasthenia gravis pacients: a 20-year review. Ann Thorac Surg 62: 853–859. Link: https://goo.gl/eHmreg

Jaretzki A, Penn AS, Younger DS, Wolff M, Olarte MR, et al. (1988) “Maximal” thymectomy for myasthenia gravis: results. J Thorac Cardiovasc Surg 95: 747–757. Link: https://goo.gl/SW3NpK

Rosenberg M, Jauregui WO, De Vega ME, Herrera MR, Roncoroni AJ (1983) Recurrence of thymic hyperplasia after thymectomy in myastenia gravis. Its importance as a cause of failure of surgical treatment. Am J Med 74: 78–82. Link: https://goo.gl/t93tsL

Scott W, Detterbeck F (1999) Transsternal thymectomy for myasthenia gravis. Semin Thorac Cardiovasc Surg 11: 54–58. Link: https://goo.gl/w7w8hQ

Ferguson MK (1999) Transcervical thymectomy. Semin Thorac Cardiovasc Surg 11: 59–64. Link: https://goo.gl/Cn6qnR

Yim AP, Kay RL, Izzat MB, Ng SK (1999) Video-assisted thoracoscopic thymectomy for myasthenia gravis. Semin Thorac Cardiovasc Surg 11: 65–73. Link: https://goo.gl/5BpgB8

Ruckert JC, Walter M, Muller JM (2000) Pulmonary function after thoracoscopic thymectomy versus median sternotomy for myasthenia gravis. Ann Thorac Surg 70: 1656–1661. Link: https://goo.gl/5EAbc3

Campos JRM (2000) Invited commentary. Ann Thorac Surg 70: 1423–1425. Link: https://goo.gl/bTcWZv

Klingen G, Johansson L, Westerholm CJ, Sundstroom C (1977) Transcervical thymectomy with the aid of mediastinoscopy for myastenia gravis: eight years’ experience. Ann Thorac Surg 23: 342–347. Link: https://goo.gl/vuHkbm