Tansel Turkan, Onursal Ertan, Barlas Semih, Tireli Emin, Alpagut Ufuk
Department of Cardiovascular Surgery, Istanbul University School of Medicine, Capa, Istanbul 34390, Turkey.
Surg Today. 2003;33(9):666-70. doi: 10.1007/s00595-003-2584-5.
To clarify the factors that influence improvement and remission after thymectomy for patients with nonthymomatous myasthenia gravis (MG).
We retrospectively reviewed 204 patients with nonthymomatous MG who underwent thymectomy and anterior mediastinal dissection through a partial median sternotomy, between 1980 and 2001, and examined whether age, sex, preoperative classification, and duration of symptoms influenced their prognosis.
There was no perioperative or hospital mortality. The mean follow-up period was 7.2 +/- 1.2 years, with early and late postoperative remission rates of 44.6% and 73%, respectively. Seven patients died; two from pneumonia and five from causes unrelated to MG. Preoperative treatment and classification, duration of symptoms, age, and sex did not seem to have a significant influence on remission, but the response to thymectomy was greater in patients with thymic hyperplasia. Remission and improvement rates were significantly better at the end of the first year, with the same status found at the last follow-up.
Thymectomy is an effective and highly curative method of treatment for patients. with MG. It provides excellent symptomatic improvement, which is enhanced over the long term.
阐明影响非胸腺瘤性重症肌无力（MG）患者胸腺切除术后病情改善和缓解的因素。
我们回顾性分析了1980年至2001年间通过部分正中胸骨切开术接受胸腺切除术和前纵隔清扫术的204例非胸腺瘤性MG患者，研究年龄、性别、术前分类和症状持续时间是否影响其预后。
围手术期或住院期间无死亡病例。平均随访期为7.2±1.2年，术后早期和晚期缓解率分别为44.6%和73%。7例患者死亡；2例死于肺炎，5例死于与MG无关的原因。术前治疗和分类、症状持续时间、年龄和性别似乎对缓解无显著影响，但胸腺增生患者对胸腺切除术的反应更大。第一年结束时缓解和改善率明显更好，最后一次随访时情况相同。
胸腺切除术是治疗MG患者的一种有效且治愈率高的方法。它能显著改善症状，且长期效果更佳。
