HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Frist, W. H. Articles by Bender, H. W. Search for Related Content PubMed PubMed Citation Articles by Frist, W. H. Articles by Bender, H. W., Jr

The Annals of Thoracic Surgery, Vol 57, 334-338, Copyright © 1994 by The Society of Thoracic Surgeons

ARTICLES

Thymectomy for the myasthenia gravis patient: factors influencing outcome

WH Frist, S Thirumalai, CB Doehring, WH Merrill, JR Stewart, GM Fenichel and HW Bender Jr
Department of Cardiac and Thoracic Surgery, Vanderbilt University Medical Center, Nashville, Tennessee.

Thymectomy is a therapeutic option for patients with myasthenia gravis with moderate to severe disability. To document the efficacy of thymectomy coupled with medical therapy to treat this disease and to identify clinical factors that influence outcome, the clinical courses of all 46 patients (12 male and 34 female; mean age, 30 +/- 16 years) with myasthenia gravis who underwent thymectomy through a median sternotomy at a single institution over a 21-year period were reviewed. Clinical staging was determined preoperatively, at 1 month, 6 months, and 12 months postoperatively, and at last follow-up (mean time, 75 months postoperatively) using the Oosterhuis classification. Changes in severity of illness were graded as "deteriorated," "unchanged," "improved," or "much improved." Preoperative Oosterhuis classification was 3.3 +/- 1.1 and at last follow-up, 1.4 +/- 1.2 (p = 0.022). At last follow-up, 40 patients (87%) were in the improved or much improved category, and 6 patients were in the deteriorated or unchanged category. Status at 1 month, 6 months, and 12 months after operation predicted outcome at last follow-up visit (p = 0.007, p = 0.005, and p = 0.001, respectively). Clinical factors that positively influenced outcome were age less than 45 years (p = 0.004), female sex (p = 0.0309), and preoperative stage (p = 0.021).

This article has been cited by other articles:

				S.-F. Ko, C.-C. Huang, M.-J. Hsieh, S.-H. Ng, C.-C. Lee, C.-C. Lee, T.-K. Lin, M.-C. Chen, and L. Lee 31P MR Spectroscopic Assessment of Muscle in Patients with Myasthenia Gravis before and after Thymectomy: Initial Experience Radiology, April 1, 2008; 247(1): 162 - 169. [Abstract] [Full Text] [PDF]

				H. K. Kim, M. S. Park, Y. S. Choi, K. Kim, Y. M. Shim, J. Han, B. J. Kim, and J. Kim Neurologic outcomes of thymectomy in myasthenia gravis: Comparative analysis of the effect of thymoma J. Thorac. Cardiovasc. Surg., September 1, 2007; 134(3): 601 - 607. [Abstract] [Full Text] [PDF]

				H. Kattach, K. Anastasiadis, J. Cleuziou, C. Buckley, B. Shine, R. Pillai, and C. Ratnatunga Transsternal Thymectomy for Myasthenia Gravis: Surgical Outcome Ann. Thorac. Surg., January 1, 2006; 81(1): 305 - 308. [Abstract] [Full Text] [PDF]

				A. Granetzny, A. Hatem, A. Shalaby, and A. Boseila Manubriotomy versus median sternotomy in thymectomy for myasthenia gravis. Evaluation of the pulmonary status Eur. J. Cardiothorac. Surg., March 1, 2005; 27(3): 361 - 366. [Abstract] [Full Text] [PDF]

				M. Tsuchida, Y. Yamato, T. Souma, K. Yoshiya, T. Watanabe, T. Aoki, and J.-i. Hayashi Efficacy and safety of extended thymectomy for elderly patients with myasthenia gravis Ann. Thorac. Surg., June 1, 1999; 67(6): 1563 - 1567. [Abstract] [Full Text] [PDF]

				I. P. Nieto, J. P. P. Robledo, M. C. Pajuelo, J. A. R. Montes, J. G. Giron, J. G. Alonso, and L. G. Sancho Prognostic factors for myasthenia gravis treated by thymectomy: review of 61 cases Ann. Thorac. Surg., June 1, 1999; 67(6): 1568 - 1571. [Abstract] [Full Text] [PDF]

				M. J. Mack, R. J. Landreneau, A. P. Yim, S. R. Hazelrigg, and G. R. Scruggs RESULTS OF VIDEO-ASSISTED THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS J. Thorac. Cardiovasc. Surg., November 1, 1996; 112(5): 1352 - 1360. [Abstract] [Full Text]

				H. Nakamura, Y. Taniguchi, Y. Suzuki, Y. Tanaka, K. Ishiguro, M. Fukuda, H. Hara, and T. Mori DELAYED REMISSION AFTER THYMECTOMY FOR MYASTHENIA GRAVIS OF THE PURELY OCULAR TYPE J. Thorac. Cardiovasc. Surg., August 1, 1996; 112(2): 371 - 375. [Abstract] [Full Text]

				F. C. Detterbeck, W. W. Scott, J. F. Howard Jr, T. M. Egan, B. A. Keagy, P. J. K. Starek, M. R. Mill, and B. R. Wilcox One Hundred Consecutive Thymectomies for Myasthenia Gravis Ann. Thorac. Surg., July 1, 1996; 62(1): 242 - 245. [Abstract] [Full Text]

				J. A. Swain Myasthenia Gravis Ann. Thorac. Surg., July 1, 1995; 60(1): 223 - 224. [Full Text]