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Surgical treatment for myasthenia gravis
A new surgical technique for thymectomy is presented. Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis...
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Published in: | Thorax 1987-03, Vol.42 (3), p.199-204 |
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container_title | Thorax |
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description | A new surgical technique for thymectomy is presented. Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis and 17 with thymomas) and conventional median sternotomy in 80. In myasthenic patients small transverse sternotomy enabled radical thymectomy to be performed with an uneventful postoperative course and very good cosmetic results. There were no hospital deaths among patients with myasthenia gravis after thymectomy. The long term results, assessed after 18-24 months, were good: the total remission rate was 39.5%, and there was a great improvement in 48.5% and an improvement in 9%. After thymectomy about 30% of patients received supplementary treatment with prednisone. A correlation between the duration of symptoms and the result of thymectomy was established: the shorter the duration of myasthenia gravis the better the results. In the small group of 20 patients with thymomas two died in hospital. In 12 patients with encapsulated thymic tumours the long term results were similar to those in patients with myasthenia gravis, whereas in patients with infiltrating thymic tumours the results were unsatisfactory. |
doi_str_mv | 10.1136/thx.42.3.199 |
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Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis and 17 with thymomas) and conventional median sternotomy in 80. In myasthenic patients small transverse sternotomy enabled radical thymectomy to be performed with an uneventful postoperative course and very good cosmetic results. There were no hospital deaths among patients with myasthenia gravis after thymectomy. The long term results, assessed after 18-24 months, were good: the total remission rate was 39.5%, and there was a great improvement in 48.5% and an improvement in 9%. After thymectomy about 30% of patients received supplementary treatment with prednisone. A correlation between the duration of symptoms and the result of thymectomy was established: the shorter the duration of myasthenia gravis the better the results. In the small group of 20 patients with thymomas two died in hospital. In 12 patients with encapsulated thymic tumours the long term results were similar to those in patients with myasthenia gravis, whereas in patients with infiltrating thymic tumours the results were unsatisfactory.</description><identifier>ISSN: 0040-6376</identifier><identifier>EISSN: 1468-3296</identifier><identifier>DOI: 10.1136/thx.42.3.199</identifier><identifier>PMID: 3616980</identifier><identifier>CODEN: THORA7</identifier><language>eng</language><publisher>London: BMJ</publisher><subject>Adult ; Biological and medical sciences ; Diseases of striated muscles. Neuromuscular diseases ; Female ; Follow-Up Studies ; Humans ; Male ; Medical sciences ; Middle Aged ; Myasthenia Gravis - etiology ; Myasthenia Gravis - surgery ; Neurology ; Thymectomy - methods ; Thymoma - complications ; Thymoma - surgery ; Thymus Neoplasms - complications ; Thymus Neoplasms - surgery ; Time Factors</subject><ispartof>Thorax, 1987-03, Vol.42 (3), p.199-204</ispartof><rights>1987 INIST-CNRS</rights><rights>Copyright BMJ Publishing Group LTD Mar 1987</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b467t-e37d9f63e2836ee7d61e9baa3542a87c4efbc42055ccaa817bc37d87271723c23</citedby><cites>FETCH-LOGICAL-b467t-e37d9f63e2836ee7d61e9baa3542a87c4efbc42055ccaa817bc37d87271723c23</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC460689/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC460689/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,315,733,786,790,891,27957,27958,53827,53829</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=8098912$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/3616980$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Otto, T J</creatorcontrib><creatorcontrib>Strugalska, H</creatorcontrib><title>Surgical treatment for myasthenia gravis</title><title>Thorax</title><addtitle>Thorax</addtitle><description>A new surgical technique for thymectomy is presented. Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis and 17 with thymomas) and conventional median sternotomy in 80. In myasthenic patients small transverse sternotomy enabled radical thymectomy to be performed with an uneventful postoperative course and very good cosmetic results. There were no hospital deaths among patients with myasthenia gravis after thymectomy. The long term results, assessed after 18-24 months, were good: the total remission rate was 39.5%, and there was a great improvement in 48.5% and an improvement in 9%. After thymectomy about 30% of patients received supplementary treatment with prednisone. A correlation between the duration of symptoms and the result of thymectomy was established: the shorter the duration of myasthenia gravis the better the results. In the small group of 20 patients with thymomas two died in hospital. In 12 patients with encapsulated thymic tumours the long term results were similar to those in patients with myasthenia gravis, whereas in patients with infiltrating thymic tumours the results were unsatisfactory.</description><subject>Adult</subject><subject>Biological and medical sciences</subject><subject>Diseases of striated muscles. Neuromuscular diseases</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myasthenia Gravis - etiology</subject><subject>Myasthenia Gravis - surgery</subject><subject>Neurology</subject><subject>Thymectomy - methods</subject><subject>Thymoma - complications</subject><subject>Thymoma - surgery</subject><subject>Thymus Neoplasms - complications</subject><subject>Thymus Neoplasms - surgery</subject><subject>Time Factors</subject><issn>0040-6376</issn><issn>1468-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1987</creationdate><recordtype>article</recordtype><recordid>eNp9kEtPGzEUha2qKATaXbeVIoGABZP62h4_FixQBKVSJBZt19Ydx5NMNA-wZyL49zXKKCpddOXF-Y59_BHyBegcgMtv_eZlLticz8GYD2QKQuqMMyM_kimlgmaSK3lMTmLcUko1gJqQCZcgjaZTcvVzCOvKYT3rg8e-8W0_K7swa14x9hvfVjhbB9xV8RM5KrGO_vN4npLf93e_Fg_Z8vH7j8XtMiuEVH3muVqZUnLPNJfeq5UEbwpEnguGWjnhy8IJRvPcOUQNqnCpoRVToBh3jJ-Sm_29T0PR-JVLgwLW9ilUDYZX22Fl3ydttbHrbmeFpFKb1L8Y-6F7HnzsbVNF5-saW98N0Solc520JfDsH3DbDaFNf7OgFHDIOehEXe8pF7oYgy8PS4DaN_026beCWW6T_oR__Xv9AR59p_x8zDEm6WXA1lXxgGlqtIE3CZd7rGi2_3_wD9Onmf8</recordid><startdate>19870301</startdate><enddate>19870301</enddate><creator>Otto, T J</creator><creator>Strugalska, H</creator><general>BMJ</general><general>BMJ Publishing Group LTD</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>BTHHO</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>19870301</creationdate><title>Surgical treatment for myasthenia gravis</title><author>Otto, T J ; Strugalska, H</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b467t-e37d9f63e2836ee7d61e9baa3542a87c4efbc42055ccaa817bc37d87271723c23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1987</creationdate><topic>Adult</topic><topic>Biological and medical sciences</topic><topic>Diseases of striated muscles. Neuromuscular diseases</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myasthenia Gravis - etiology</topic><topic>Myasthenia Gravis - surgery</topic><topic>Neurology</topic><topic>Thymectomy - methods</topic><topic>Thymoma - complications</topic><topic>Thymoma - surgery</topic><topic>Thymus Neoplasms - complications</topic><topic>Thymus Neoplasms - surgery</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Otto, T J</creatorcontrib><creatorcontrib>Strugalska, H</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>ProQuest Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>AUTh Library subscriptions: ProQuest Central</collection><collection>BMJ Journals</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Thorax</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Otto, T J</au><au>Strugalska, H</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Surgical treatment for myasthenia gravis</atitle><jtitle>Thorax</jtitle><addtitle>Thorax</addtitle><date>1987-03-01</date><risdate>1987</risdate><volume>42</volume><issue>3</issue><spage>199</spage><epage>204</epage><pages>199-204</pages><issn>0040-6376</issn><eissn>1468-3296</eissn><coden>THORA7</coden><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>A new surgical technique for thymectomy is presented. Three hundred and seventeen patients with myasthenia gravis and 20 with thymomas who had myasthenic symptoms were operated on. The new surgical approach--a small transverse sternotomy--was used in 257 cases (in 240 patients with myasthenia gravis and 17 with thymomas) and conventional median sternotomy in 80. In myasthenic patients small transverse sternotomy enabled radical thymectomy to be performed with an uneventful postoperative course and very good cosmetic results. There were no hospital deaths among patients with myasthenia gravis after thymectomy. The long term results, assessed after 18-24 months, were good: the total remission rate was 39.5%, and there was a great improvement in 48.5% and an improvement in 9%. After thymectomy about 30% of patients received supplementary treatment with prednisone. A correlation between the duration of symptoms and the result of thymectomy was established: the shorter the duration of myasthenia gravis the better the results. In the small group of 20 patients with thymomas two died in hospital. In 12 patients with encapsulated thymic tumours the long term results were similar to those in patients with myasthenia gravis, whereas in patients with infiltrating thymic tumours the results were unsatisfactory.</abstract><cop>London</cop><pub>BMJ</pub><pmid>3616980</pmid><doi>10.1136/thx.42.3.199</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Adult Biological and medical sciences Diseases of striated muscles. Neuromuscular diseases Female Follow-Up Studies Humans Male Medical sciences Middle Aged Myasthenia Gravis - etiology Myasthenia Gravis - surgery Neurology Thymectomy - methods Thymoma - complications Thymoma - surgery Thymus Neoplasms - complications Thymus Neoplasms - surgery Time Factors |
title | Surgical treatment for myasthenia gravis |
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