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]

The technical key steps of the surgical procedure are presented in a step by step way. Consequently, this operating technique is well standardized for the management of this condition. Related specialties [websurg.com]

• Pain

  The primary outcomes were postoperative pain score (visual analog scale) at 6, 12, 24, 48, and 72 h, and 1-month postoperatively, and morphine consumption in the first 48 h. Secondary outcomes were surgical and clinical results. [ncbi.nlm.nih.gov]

  excessive bleeding, or any discharge from the incision site Pain that you cannot control with the medications you were given Cough, difficulty breathing, or chest pain Pain, burning, urgency, or frequency of urination, or persistent bleeding in the [upstate.edu]

  Pain levels are mild after transcervical or VATS thymectomies. There can be more pain with the trans-sternal approach, but it is temporary and can be controlled through use of pain medications. Pain usually resolves in three to five days. [nm.org]

• Weakness

  […] generalized weakness, bulbar dysfunction, or both, and 4 = severe generalized weakness, respiratory dysfunction, or both. [ncbi.nlm.nih.gov]

  Seventy-one percent of the patients had a very significant improvement (no generalized weakness and no requirement for the medication Mestinon). [cardiothoracicsurgery.wustl.edu]

• Surgical Procedure

  The technical key steps of the surgical procedure are presented in a step by step way. Consequently, this operating technique is well standardized for the management of this condition. Related specialties [websurg.com]

  To date, there is no consensus on surgical procedure choice. [ncbi.nlm.nih.gov]

• Fatigue

  She denied shortness of breath, dysarthria, and fatigue. She had been diagnosed with MG 6 years previously at the Neurology Department of our hospital. [ncbi.nlm.nih.gov]

  Myasthenia gravis is believed to be an autoimmune disorder characterized by increasing fatigue with exertion. [doi.org]

• Asymptomatic

  We used complete stable remission (CSR), termed an asymptomatic status without medication for at least 12 months; general complete remission (GCR), termed an asymptomatic status with or without some form of therapy excluding cholinesterase inhibitors, [ncbi.nlm.nih.gov]

  Patients’ symptoms were graded before surgery and at the most recent (within the last 6 months) postoperative time point, using the modified Osserman classification: 0 = asymptomatic, 1 = ocular signs and symptoms, 2 = mild generalized weakness, 3 = moderate [doi.org]

  […] conclude that evidence-based reviews have shown that relative rates of thymectomy patients compared with non-thymectomy patients attaining outcome indicate that the former group of patients is more likely to achieve medication-free remission, become asymptomatic [academic.oup.com]

  Only one patient with MG was asymptomatic (Modified Osserman Stage 0) and was counseled to undergo thymectomy due to an enlarging thymic nodule on serial imaging with computed tomography (CT). [annalscts.com]

• Respiratory Insufficiency

  PLEX and IVIg are appropriately used as short-term treatments in patients with MG with life-threatening signs such as respiratory insufficiency or dysphagia; in preparation for surgery in patients with significant bulbar dysfunction; when a rapid response [emedicine.medscape.com]

• Nausea

  Call Your Doctor Call your doctor if you are not getting better or you have: Signs of infection, such as fever and chills Redness, swelling, excessive bleeding, or any discharge from the incision Pain that you cannot control with medicine Lasting nausea [winchesterhospital.org]

  […] bleeding, or any discharge from the incision site Pain that you cannot control with the medications you were given Cough, difficulty breathing, or chest pain Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine Persistent nausea [upstate.edu]

  Paravertebral blocks have comparable analgesia, less hypotension, nausea, and urinary retention. Drawbacks: short acting, intercostals have rapid absorption, require multiple levels and multiple injections. [clinicalpainadvisor.com]

• Vomiting

  Your Doctor Call your doctor if you are not getting better or you have: Signs of infection, such as fever and chills Redness, swelling, excessive bleeding, or any discharge from the incision Pain that you cannot control with medicine Lasting nausea or vomiting [winchesterhospital.org]

  […] discharge from the incision site Pain that you cannot control with the medications you were given Cough, difficulty breathing, or chest pain Pain, burning, urgency, or frequency of urination, or persistent bleeding in the urine Persistent nausea and vomiting [upstate.edu]

• Diplopia

  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]

  She had a two-year history of myasthenia gravis, presenting with diplopia, ptosis, and mild generalized weakness (stage IIA according to the Osserman classification). The physical examination was unremarkable. [scielo.br]

  • Ocular symptoms as diplopia and ptosis,• Weakness and fatigue transiently. 5. [slideshare.net]

  A thorough history and physical should be performed, with specific questions directed towards eliciting a history of myasthenia gravis (ptosis, diplopia, fatigable chewing dysarthria, dysphagia, fatigability). [jovs.amegroups.com]

• Prolapse

  R Surgery Rectal prolapse repair Rectal prolapse repair is surgery to fix a rectal prolapse. [mountsinai.org]

  […] tachycardia) Heart attack (acute myocardial infarction) Heart failure (cardiomyopathy) Heart rhythm disorders (arrhythmias) Long QT syndrome (inherited arrhythmias) Marfan Syndrome Mitral valve disease (mitral regurgitation and mitral stenosis) Mitral valve prolapse [uwhealth.org]

• Blepharoptosis

  Effect of local heat versus ice on blepharoptosis resulting from ocular myasthenia. Ophthalmology. 2000 Dec. 107(12):2209-14. [Medline]. Benatar M. A systematic review of diagnostic studies in myasthenia gravis. [medscape.com]

• Muscle Weakness

  This causes muscle weakness with symptoms that can include in double vision or blurred vision (eye muscle weakness), drooping eyelids (eyelid muscle weakness), difficulty with speaking and swallowing (throat muscle weakness) and weakness of the limbs. [my.clevelandclinic.org]

  No significant differences were detected with regard to myasthenic crisis, wound infection, and muscle weakness improvement. [ncbi.nlm.nih.gov]

• Tremor

  In comparison, robotic surgery uses extremely flexible instruments, which can mimic the movement of the human wrist – without any tremor. Surgeons are able to operate more easily and intuitively. [swedish.org]

  The instrument arms have seven degrees of freedom, promoting motion scaling and tremor filtering. [scielo.br]

  Hand tremor is filtered out by a 6-Hz motion filter. The surgeon observes the operating field through console binoculars. The image comes from a manoeuvrable high-definition stereoscopic camera (endoscope) attached to one of the robot arms. [jovs.amegroups.com]

• Paresis

  Phrenic nerve injury resulting in diaphragmatic paralysis and paresis of recurrent laryngeal nerve were some known complications. Diet and Activity Patients with MG may experience difficulty chewing and swallowing because of oropharyngeal weakness. [emedicine.medscape.com]

• Confusion

  The studies for thymectomy treatment for Myasthenia Gravis are confusing because of different definitions of what “remission” is. [netwellness.org]

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]

[…] 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]

The objective of this study was to review the efficacy of our applied stage-based treatment for thymoma in due consideration of thymectomy. [ncbi.nlm.nih.gov]

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]

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]

[…] 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]

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]

Crossref PubMed Google Scholar In an extensive surgical treatise that reviewed previous pathologic and experimental work, Blalock presented a pathophysiologic theory as to the role of thymectomy in MG. [jtcvs.org]

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]