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Contribution of thymectomy in the treatment of myasthenia gravis

Par : Contributeur(s) : Type de matériel : TexteTexteLangue : français Détails de publication : 2023. Ressources en ligne : Abrégé : The aim of our study is to show the contribution of thymectomies in the treatment of myasthenia gravis.Patients and method: This was a descriptive and retrospective study carried out in the thoracic surgery department of the Hassan II University Hospital in Fes during the period from May 2009 to May 2018. It concerned all patients who had undergone a thymectomy by median sternotomy for myasthenia gravis. The results of this surgery were evaluated by a neurologist using the Myasthenia Gravis Foundation of America (MGFA) scale. Results: This was a series of 34 myasthenic patients who underwent extended thymectomy, including 24 women and 10 men with an average age of 34. Clinical signs were classified according to Osserman’s myasthenic classification. After surgery, a significant decrease in symptoms and drug doses was observed in 68% of cases, while no change was noted in 18%. In addition, univariate analysis showed a statistically significant correlation (p = 0.02) between female sex and improvements after surgery. Likewise, the improved patients had B1 and B2 thymoma in 56 and 44% of cases, respectively, while those in the “unchanged” group had B1 in 50% of cases and B3 thymoma in 50%. Conclusion: Thymectomy enables clinical improvement and better quality of life in myasthenic patients with very low morbidity and mortality. It must be performed in centers with experience in this field and intensive care units accustomed to this kind of treatment.
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The aim of our study is to show the contribution of thymectomies in the treatment of myasthenia gravis.Patients and method: This was a descriptive and retrospective study carried out in the thoracic surgery department of the Hassan II University Hospital in Fes during the period from May 2009 to May 2018. It concerned all patients who had undergone a thymectomy by median sternotomy for myasthenia gravis. The results of this surgery were evaluated by a neurologist using the Myasthenia Gravis Foundation of America (MGFA) scale. Results: This was a series of 34 myasthenic patients who underwent extended thymectomy, including 24 women and 10 men with an average age of 34. Clinical signs were classified according to Osserman’s myasthenic classification. After surgery, a significant decrease in symptoms and drug doses was observed in 68% of cases, while no change was noted in 18%. In addition, univariate analysis showed a statistically significant correlation (p = 0.02) between female sex and improvements after surgery. Likewise, the improved patients had B1 and B2 thymoma in 56 and 44% of cases, respectively, while those in the “unchanged” group had B1 in 50% of cases and B3 thymoma in 50%. Conclusion: Thymectomy enables clinical improvement and better quality of life in myasthenic patients with very low morbidity and mortality. It must be performed in centers with experience in this field and intensive care units accustomed to this kind of treatment.

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