Presentation
Furthermore, being less painful in the postoperative period, it presents a less pronounced impairment of pulmonary function, and it presents good cosmetic effect. [ncbi.nlm.nih.gov]
Entire Body System
- Vietnamese
The clinical characteristics of thymoma and the outcomes of video-assisted thoracoscopic thymectomy in Vietnamese patients are still lacking. [ncbi.nlm.nih.gov]
Respiratoric
- Sputum
A 67-year old man presented with cough and bloody sputum. Chest computed tomography showed an anterior mediastinal mass with a right hilar nodule. A right upper sleeve lobectomy and a thymectomy were performed via a VATS approach. [ncbi.nlm.nih.gov]
Gastrointestinal
- Intermittent Dysphagia
We report the case of a 22-year-old female with a 6-year history of MG presented with bilateral ptosis, diplopia, and intermittent dysphagia. She denied shortness of breath, dysarthria, and fatigue. [ncbi.nlm.nih.gov]
Cardiovascular
- Cardiomegaly
Relative contraindications for a left-sided VATS approach include patients with a history of pleurodesis in the left pleural cavity or those with severe cardiomegaly, in whom a right-sided approach is preferred. [ctsnet.org]
Musculoskeletal
- Migratory Polyarthritis
This case report describes a 50-year-old man who presented with migratory polyarthritis and an anterior mediastinal mass that proved to be a thymoma. [ncbi.nlm.nih.gov]
- Proximal Muscle Weakness
On examination,she had moderately severe fatigable proximal muscle weakness and ptosis. [ncbi.nlm.nih.gov]
- Leg Weakness
Twin A was a 19-year-old white woman who presented with an 8-week history of intermittent leg weakness, causing her to fall during activities, such as climbing stairs. [ncbi.nlm.nih.gov]
Urogenital
- Secondary Amenorrhea
We describe an eighteen-year-old girl with MG who was admitted to our clinic with secondary amenorrhea and diagnosed as autoimmune oophoritis. Since her myasthenic symptoms did not resolve with anticholinesterase therapy, thymectomy was performed. [ncbi.nlm.nih.gov]
Neurologic
- Neglect
Preoperative anxiety (POA) is common but typically neglected in MG patients. [ncbi.nlm.nih.gov]
Workup
Pre-operative Workup and Preparation Computed tomography – this is almost always obtained pre-operatively if a mediastinal mass is suspected and includes contrast enhancement to evaluate the involvement of the nearby vascular structures. [insidesurgery.com]
You may be required to undergo several diagnostic tests, including: A blood workup EKG CT Scan PET Scan What to Expect Thymectomy is performed under general anesthesia. [northshore.org]
Edrophonium is primarily but rarely used as a diagnostic tool to predict the response to longer-acting cholinesterase inhibitors (see Workup). [43] AChE inhibitors have a wide variability in the effective dose, depending on the severity and current activity [emedicine.medscape.com]
X-Ray
- Pericardial Effusion
The use of cautery on the pericardium should be minimized as this reduces the chance of pericarditis and pericardial effusion postoperatively. The diaphragmatic dissection of the mediastinal fat and gland is done in a similar fashion. [medical-diagonosis.wonderhowto.com]
Other ECG Findings
- Abnormal ECG
Myasthenia gravis is not usually considered in the differential diagnosis of conditions associated with an abnormal ECG. [ncbi.nlm.nih.gov]
Treatment
The effectiveness of extended thymectomy for the treatment of myasthenia gravis is well documented. [ncbi.nlm.nih.gov]
[…] of open or thoracoscopic thymectomy compared to medical treatment in managing Myasthenia gravis without thymomas Read Summary - More: Economic Evaluations Comparison of Conservative Treatment and Thymectomy on Myasthenia Gravis Outcome Source: PubMed [evidence.nhs.uk]
Prognosis
Finally, thymic lymphoid hyperplasia and severe symptoms may negatively affect prognosis of MG following thymectomy. Copyright © 2017 Elsevier B.V. All rights reserved. [ncbi.nlm.nih.gov]
They emphasize that the duration of the disease is a better indicator of postresection prognosis than gender or youth, concluding that the operation should be indicated early after the onset of symptoms. [peertechz.com]
Beghi E, Antozzi C, Batocchi AP, Corneliio F, Cosi V, Evoli A, Lombardi M, Mantegazza R, Monticelli ML, Piccolo G, Tonali P, Trevisan D, Zarrelli M: Prognosis of myasthenia gravis: A multicenter follow-up study of 844 patients. [karger.com]
Thymic carcinoma and thymic carcinoid have poor prognosis regardless of the stage of the lesion. Postoperative adjuvant therapy may be beneficial for malignant thymoma in selected cases. References Gronseth GS, Barohn RJ. [ctsnet.org]
Etiology
Abstract Following thorascopic thymectomy performed because of myasthenia gravis, a 25-year-old man was affected by fulminant hepatic failure (FHF) of unknown etiology. [ncbi.nlm.nih.gov]
Knowledge of the pathogenesis of MG has enabled the development of different therapeutic approaches on a symptomatic and etiologic basis. [annalscts.com]
As the disease has a relatively low incidence and different etiologies, the construction of homogeneous groups in enough number is quite difficult. [ojrd.biomedcentral.com]
Myasthenia gravis: a comprehensive review of immune dysregulation and etiological mechanisms. J Autoimmun 2014 ;52: 90 - 100 23. Alshekhlee A, Miles JD, Katirji B, Preston DC, Kaminski HJ. [nejm.org]
Epidemiology
[…] compare the morbidity and mortality of three techniques [cervicotomy with upper sternotomy versus sternotomy versus video-assisted thoracic surgery (VATS)/robotic-assisted thoracic surgery (RATS)] from the national database EPITHOR and to analyse French epidemiology [ncbi.nlm.nih.gov]
A systematic review of population based epidemiological studies in myasthenia gravis. BMC Neurol 2010;10:46. Cea G, Benatar M, Verdugo RJ, Salinas RA. Thymectomy for non-thymomatous myasthenia gravis. [discover.dc.nihr.ac.uk]
Epidemiologic evidence for a changing natural history of myasthenia gravis. Neurology 1996;47:1233-8. 7. Oosterhuis HJ. The natural course of myasthenia gravis: A long term follow up study. J Neurol Neurosurg Psychiatry 1989;52:1121-7. 8. [neurologyindia.com]
For ethical and epidemiological reasons and due to the pathogenesis of MG a single-center study design with higher level of evidence seems difficult to achieve. [edoc.hu-berlin.de]
Pathophysiology
Progressive disease seen after thymectomy in this patient has potential implications regarding the pathophysiological characteristics of microscopic polyangiitis and management of patients with this clinical association. [ncbi.nlm.nih.gov]
The pathophysiology is related to the presence of acetylcholine receptors generated in the thymus, which ultimately lead to the symptoms. [scielo.br]
Prevention
To prevent serious complications, we suggest that patients who have undergone both thymectomy and radiation therapy be monitored for immunodeficiency. [ncbi.nlm.nih.gov]
In thymic tumors, thymus removal (thymectomy) can be used to prevent spread of disease. [drdimaio.com]
Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications. Average Hospital Stay The usual length of stay is 1-3 days. Your doctor may choose to keep you longer if complications arise. [winchesterhospital.org]