Resultado da timectomia ampliada no tratamento de pacientes com Miastenia gravis



Título del documento: Resultado da timectomia ampliada no tratamento de pacientes com Miastenia gravis
Revista: Jornal brasileiro de pneumologia
Base de datos: PERIÓDICA
Número de sistema: 000297449
ISSN: 1806-3713
Autors: 1


Institucions: 1Universidade Estadual Paulista "Julio de Mesquita Filho", Faculdade de Medicina de Botucatu, Botucatu, Sao Paulo. Brasil
Any:
Període: Mar-Abr
Volum: 30
Número: 2
Paginació: 115-120
País: Brasil
Idioma: Portugués
Tipo de documento: Artículo
Enfoque: Caso clínico, analítico
Resumen en inglés BACKGROUND: Extended thymectomy is one of several types of thymectomy. Literature suggests that the outcome and prognosis will be enhanced by performing a more extensive resection of the gland and of the anterior mediastinum tissue. OBJECTIVE: To retrospectively evaluate response of MG patients to extended thymectomy. METHOD: From August 1992 to January 2003, forty-six MG patients were submitted to preoperative plasmapheresis and extended thymectomy. According to the time elapsed since onset of symptom they were divided into three groups; < 12 months, 13 to 24 months, and > 25 months. RESULTS: There were 31 female and 15 male patients, mean age 30 years and average evolution time 26.3 months. Outpatient post-operative follow-up was on the average of 26.6 months. Level of response was good, 50% had full remission and a further 39% had good response. There was one death. The most common histopathology finding was thymic hyperplasia. Only 3 patients (6.5%) had benign thymomas; 5 (10.8%) had extra glandular thymic tissue: 2 in the perithymic fat and 3 in the pericardiac fat adjacent to the left phrenic nerve and aortal-pulmonary window. CONCLUSION: Treatment of MG by extended thymectomy is safe and efficient with high levels of complete remission. Extra glandular thymic tissue was found in some patients. As soon as diagnosis is completed, thymectomy is indicated together with plasmapheresis and medication, independent of age, onset of symptoms, and thymus pathology
Resumen en portugués CONCLUSÃO: A timectomia ampliada para tratamento da Miastenia gravis mostrou-se segura, eficiente, e apresentou alta porcentagem de remissão completa. Houve a detecção de tecido tímico extraglandular em alguns pacientes. Tão logo seja feito o diagnóstico, está indicada como terapêutica associada à plasmaferese pré-operatória e à medicamentosa, independentemente da idade, patologia tímica, e início dos sintomas
Disciplines Medicina
Paraules clau: Cirugía,
Neumología,
Terapéutica y rehabilitación,
Timectomía,
Miastenia grave,
Enfermedades neuromusculares
Keyword: Medicine,
Pneumology,
Surgery,
Therapeutics and rehabilitation,
Thymectomy,
Myasthenia gravis,
Neuromuscular diseases
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