Who will benefit from thymectomy for myasthenia gravis? Is there any role for this procedure in elderly patients?
Ann Transl Med
; 7(1): 4, 2019 Jan.
Article
en En
| MEDLINE
| ID: mdl-30788351
ABSTRACT
BACKGROUND:
The proportion of elderly patients with myasthenia gravis (MG) is increasing over time. Thoracoscopic extended thymectomy has been shown to achieve a superior short-term outcome to transsternal procedures. Therefore, the long-term clinical outcome should be re-examined, particularly in elderly patients.METHODS:
We evaluated the long-term clinical outcomes after extended thymectomy in 30 MG patients with or without thymoma. Twenty-one (70%) patients underwent surgery by 65 years of age, and the remaining 9 (30%) underwent surgery after 65 years of age. Univariate and multivariate logistic regression analyses were used to determine the influence of various factors on the improvement in MG symptoms.RESULTS:
The characteristics in the elderly patients were comparable to those in the younger patients, except for the age at surgery. Symptoms of MG improved in 4 of the 9 (44%) elderly patients and in 18 of the 21 (86%) younger patients (P=0.0192). One elderly patient who underwent transsternal thymectomy died suddenly on postoperative day 3, probably due to a MG crisis no pathological abnormalities were detected by an autopsy. A multivariate analysis identified an age at thymectomy of <65 years (P=0.0237) and a duration from the onset to thymectomy of <1 year (P=0.0405) as independent factors associated with the improvement of MG symptoms. Indeed, 4 of the 5 (80%) elderly patients who underwent thymectomy within 1 year after the onset had a favorable long-term outcome.CONCLUSIONS:
Thymectomy can be an option even in elderly patients, provided the operation is performed early after the onset.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Prognostic_studies
Idioma:
En
Revista:
Ann Transl Med
Año:
2019
Tipo del documento:
Article
País de afiliación:
Japón