Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida

Background: Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG). Aim: To describe the immediate and long-term results of extended transsternal thymectomy (ETT) in patients with MG. Material and Methods: A review of databases,...

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Autores principales:	González L.,Roberto, Riquelme U.,Alejandra, Fuentealba S.,Mario, Canales Z.,Jorge, Fuentes E.,Alberto, Saldías F.,René, Seguel S.,Enrique, Stockins L.,Aleck, Jadue T.,Andrés, Alarcón C.,Emilio
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2018
Materias:	Myasthenia Gravis Thoracic Surgery Thymectomy Thymus Hyperplasia
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000400460
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spelling	oai:scielo:S0034-988720180004004602018-07-03Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendidaGonzález L.,RobertoRiquelme U.,AlejandraFuentealba S.,MarioCanales Z.,JorgeFuentes E.,AlbertoSaldías F.,RenéSeguel S.,EnriqueStockins L.,AleckJadue T.,AndrésAlarcón C.,Emilio Myasthenia Gravis Thoracic Surgery Thymectomy Thymus Hyperplasia Background: Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG). Aim: To describe the immediate and long-term results of extended transsternal thymectomy (ETT) in patients with MG. Material and Methods: A review of databases, surgical protocols, clinical records and interviews of patients subjected to extended transsternal thymectomy for MG between 1990 and 2016. Perioperative clinical characteristics, anticholinesterase treatment, immediate and remote surgical results were analyzed and patients were followed from one to 10years. Results: We studied 58 patients aged 35 ± 14years (72%) women. In the preoperative period, according to Osserman classification, nine patients (15,5%) were in grade I, eight (13,8%) in grade IIA 8 and 40 (69%) in grade IIB. The pathological study of the surgical piece showed thymic hyperplasia in 39 cases (67,2%). Four patients had postoperative complications but none died. In the Follow-up at 1, 3, 5, 8 and 10years the Masaoka palliation rate was 71.7, 77.5, 67.7, 70.0 and 70,6% respectively. The figures for remission rate were 13.0, 15.0,19.4, 35.0 and 35,3% respectively. The figures for Zielinski positive results were 79.6, 87.5, 87.1, 90.0 and 82,4% respectively. The DeFilippi score improved by 80.4, 87.5, 87.1, 90.0 and 82.4% respectively. The Myasthenia Gravis Foundation of America Post-Intervention State improved by 67.4, 77.5, 77.5, 75.0 and 70,6% respectively. Mean Myasthenia Gravis Activities of daily living (MGADL) and Myasthenia Gravis Quality of life scale 15 (MGQOL 15) were 1.65 and 6.31 respectively. Conclusions: In selected patients with MG, extended transsternal thymectomy in MG has good immediate and long-term results.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.146 n.4 20182018-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000400460es10.4067/s0034-98872018000400460
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Myasthenia Gravis Thoracic Surgery Thymectomy Thymus Hyperplasia
spellingShingle	Myasthenia Gravis Thoracic Surgery Thymectomy Thymus Hyperplasia González L.,Roberto Riquelme U.,Alejandra Fuentealba S.,Mario Canales Z.,Jorge Fuentes E.,Alberto Saldías F.,René Seguel S.,Enrique Stockins L.,Aleck Jadue T.,Andrés Alarcón C.,Emilio Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
description	Background: Thymectomy improves clinical outcomes and decreases the need for medical treatment in patients with myasthenia gravis (MG). Aim: To describe the immediate and long-term results of extended transsternal thymectomy (ETT) in patients with MG. Material and Methods: A review of databases, surgical protocols, clinical records and interviews of patients subjected to extended transsternal thymectomy for MG between 1990 and 2016. Perioperative clinical characteristics, anticholinesterase treatment, immediate and remote surgical results were analyzed and patients were followed from one to 10years. Results: We studied 58 patients aged 35 ± 14years (72%) women. In the preoperative period, according to Osserman classification, nine patients (15,5%) were in grade I, eight (13,8%) in grade IIA 8 and 40 (69%) in grade IIB. The pathological study of the surgical piece showed thymic hyperplasia in 39 cases (67,2%). Four patients had postoperative complications but none died. In the Follow-up at 1, 3, 5, 8 and 10years the Masaoka palliation rate was 71.7, 77.5, 67.7, 70.0 and 70,6% respectively. The figures for remission rate were 13.0, 15.0,19.4, 35.0 and 35,3% respectively. The figures for Zielinski positive results were 79.6, 87.5, 87.1, 90.0 and 82,4% respectively. The DeFilippi score improved by 80.4, 87.5, 87.1, 90.0 and 82.4% respectively. The Myasthenia Gravis Foundation of America Post-Intervention State improved by 67.4, 77.5, 77.5, 75.0 and 70,6% respectively. Mean Myasthenia Gravis Activities of daily living (MGADL) and Myasthenia Gravis Quality of life scale 15 (MGQOL 15) were 1.65 and 6.31 respectively. Conclusions: In selected patients with MG, extended transsternal thymectomy in MG has good immediate and long-term results.
author	González L.,Roberto Riquelme U.,Alejandra Fuentealba S.,Mario Canales Z.,Jorge Fuentes E.,Alberto Saldías F.,René Seguel S.,Enrique Stockins L.,Aleck Jadue T.,Andrés Alarcón C.,Emilio
author_facet	González L.,Roberto Riquelme U.,Alejandra Fuentealba S.,Mario Canales Z.,Jorge Fuentes E.,Alberto Saldías F.,René Seguel S.,Enrique Stockins L.,Aleck Jadue T.,Andrés Alarcón C.,Emilio
author_sort	González L.,Roberto
title	Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
title_short	Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
title_full	Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
title_fullStr	Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
title_full_unstemmed	Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
title_sort	miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida
publisher	Sociedad Médica de Santiago
publishDate	2018
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872018000400460
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Miastenia gravis: resultados inmediatos y alejados de la timectomía transesternal extendida

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