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Original Articles: General Thoracic

Invited commentary

Cardiothoracic Surgery, Southern Illinois University School of Medicine, School of Medicine, 800 N Rutledge, Room D319, Springfield, IL 62794–9638

(Email: shazelrigg{at}siumed.edu).

This article by Yu and colleagues [1] suggests that oropharyngeal symptoms in myasthenia gravis identify patients with a more advanced disease state. As a consequence of this advanced state, these patients are at an increased risk of postoperative complications as well as a less favorable early complete response rate after thymectomy.

The criticism of the data includes the fact that the authors did not have a clear definition of postoperative pneumonia, and that although the group with oropharyngeal symptoms had statistically longer ventilator times, the extra 5 hours is not of great clinical significance. We can also note that the complete response rates were not significantly different after 3 years. Many variables were involved, such as different surgical routes and other differences that always cloud the results.

In the end, however, I would congratulate the authors for bringing to our attention a group of patients that may be at increased risk for problems. Their 5-year follow-up is fairly complete (only 10% were lost to follow-up), which is a strength of the study. Unfortunately, I do not see any reason to alter operative indications or postoperative care on the basis of these data. The patient population with myasthenia gravis already requires careful attention to potential complications after thymectomy.

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1. Yu L, Li J, Ma S, et al. Different characteristics of non-thymomatous generalized myasthenia gravis with and without oropharyngeal involvement Ann Thorac Surg 2007;84:1694-1698.[Abstract/Free Full Text]

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted 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 Author home page(s): Stephen R. Hazelrigg Permission Requests Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Hazelrigg, S. R. Search for Related Content PubMed PubMed Citation Articles by Hazelrigg, S. R. Related Collections Mediastinum Related Article