[Investigation of preoperative respiratory evaluation in four cases of myasthenia gravis undergoing extended thymectomy in the past two years].

BACKGROUND

Myasthenia gravis (MG) is an autoimmune disease. The MG patients undergoing extended thymectomy under general anesthesia are at risk for postoperative complications, such as respiratory insufficiency and crisis (cholinergic and myasthenic). We evaluated the preoperative predictive factors, which are important for postoperative respiratory control.

METHODS

Four patients undergoing extended thymectomy under general anesthesia in our hospital within the last two years (2008-2010) were studied. All patients were graded with Ossermann Classification (I, IIa, IIb, IIb), MGFA Clinical Classification (Class I, IIIb, IIIb, IIIb) and Fuchu Hospital Scoring System (2, 4, 5, 10).

RESULTS

One patient was re-intubated in postoperative 5 days due to myasthenic crisis. The patient had a high values in Fuchu Hospital Scoring System (10), longer duration of myasthenia (84 months) and higher preoperative anti-acetylcholine receptor antibody value (1,200 nmol x l(-1)).

CONCLUSIONS

This finding suggests that Fuchu Hospital Scoring System, duration of myasthenia and preoperative anti-acetylcholine receptor antibody are valuable for MG patients undergoing extended thymectomy as preoperative predictive factors. These factors are important for postoperative respiratory control.