Advisability of Thymectomy in Young Patients With Thymus-Independent Myasthenia Gravis in the Presence of Biomarkers Specific for Patients With Thymoma

Klimova, E. M.; Drozdova, L. A.; Lavinskaya, E. V.; Minukhin, D. V.; Kudrevich, A. N.

doi:10.37699/2308-7005.3.2020.13

Cited by 3 publications

(3 citation statements)

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“…Also, superior vena cava thrombosis in 6.6 % of patients while pneumonia in 6.6 % of patients. However, thromboembolism of small pulmonary arteries in 6.6 % of patients [3,11].…”

Section: Discussionmentioning

confidence: 99%

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Peculiarities of surgical tactics of patients with thymus tumors

Ponomarova

2021

TT:medicine

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The aim of the study: to study retrospective analysis results of the surgical treatment of thymus tumours for predicting long-time results. Methods. Study included 35 patients who were treated at the Department of Thoraco-abdominal Surgery from September 2019 to May 2021. The control group included 20 patients with SVCS were treated with conventional techniques, while the experimental group included 15 patients who underwent a novel bypass surgery developed by us. Results. The venous bypass was mandatorily complemented with cytoreduction. Complications in the post-operative period were reported from the experimental group and included auriculo-subclavian bypass thrombosis, post-operative complications were reported in the control group including haemorrhage from the sternotomy wound in 1 (3.3 %) case, superior vena cava thrombosis in 2 (6.6 %) cases, pneumonia in 2 (6.6 %). The relative risk of complications and lethal outcome was calculated for patients from both groups. It was found that the risk of complications was twice as high in the control group as in the experimental group (standard error of relative risk equals 0.64). Conclusion. The first mandatory step of the radical surgery in patients with thymomas with SVC invasion should be the auriculo-jugular and auriculo-subclavian bypasses, which can reduce the relative risk of post-operative complications by a factor of the risk of lethal by a factor of 3.5

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“…Also, superior vena cava thrombosis in 6.6 % of patients while pneumonia in 6.6 % of patients. However, thromboembolism of small pulmonary arteries in 6.6 % of patients [3,11].…”

Section: Discussionmentioning

confidence: 99%

“…High organization thymus tumors are a series of histological structure tumors that demonstrate options at the molecular rage of thymomas are the most common feature of neoplasms of the high vein, which occurs in 87.5 %. To designate them in 1900 H. Grandhomme and R. Scminke proposed the defenition "thymoma" [3].…”

Section: Introductionmentioning

confidence: 99%

Peculiarities of surgical tactics of patients with thymus tumors

Ponomarova

2021

TT:medicine

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“…In the USA, 15,000 new SVCS cases are reported annually, up to 85 % of which are developed due to a primary or secondary tumour lesion. Around 73-85 % of all CVCS cases of tumour genesis are due to locally advanced thymomas [6,7].…”

Section: Introductionmentioning

confidence: 99%

Outcomes of surgical reconstruction of the superior vena cava syndrome in patients with locally advanced thymomas

et al. 2021

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The aim of the study: to study and demonstrate the potential and technical aspects of the surgical treatment of locally advanced thymus tumours with the tumour infiltrate affecting superior vena cava and its branches. Methods. 56 patients with locally advanced thymomas complicated by SVCS were study. The control group included 30 patients with SVCS were treated with conventional techniques, while the experimental group included 26 patients who underwent a novel bypass surgery developed by us. Results. Based on our observations, patients tolerated these surgeries much better. The venous bypass was mandatorily complemented with cytoreduction. Auriculo-jugular (left and right) and auriculo-subclavian (left and right) bypasses were used in our observations Complications in the post-operative period were reported from the experimental group and included auriculo-subclavian bypass thrombosis, post-operative complications were reported in the control group including haemorrhage from the sternotomy wound in 1 (3.3 %) case, superior vena cava thrombosis in 2 (6.6 %) cases, pneumonia in 2 (6.6 %) cases and thromboembolism of small pulmonary arteries in 2 (6.6 %) cases. Post-operative lethality in the study groups was reported in the control and in the experimental group. Total lethality rate was 8.9 % (5 patients). The relative risk of complications and lethal outcome was calculated for patients from both groups. It was found that the risk of complications was twice as high in the control group as in the experimental group (standard error of relative risk equals 0.64), whereas the risk of lethal outcome increased by a factor of 3.5 in the control group (standard error of relative risk equals 1.09) Conclusion. It has been established that the superior vena cava syndrome in patients with locally advanced thymoma is an emergency condition whose surgical correction must be personalised depending on the anatomic and topographic classification of SVC lesion types. It is known that an obligatory pre-condition of the perioperative period in this category of patients is an adequate vascular approach to the superior vena cava system. The first mandatory step of the radical surgery in patients with locally advanced thymomas with SVC invasion should be the auriculo-jugular and auriculo-subclavian bypasses, which can reduce the relative risk of post-operative complications by a factor of the risk of lethal by a factor of 3.5.

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Rehabilitation of the patients with myasthenia gravis as an Integral part of the patient’s Treatment Algorithm in the postoperative period

et al. 2021

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Aim: The purpose of this article is to determine the role of rehabilitation in the structure of the treatment algorithm for patients with myasthenia gravis. materials and methods: All patients admitted to the SI «Zaycev V.T. Institute of General and Urgent surgery of National Academy of Medical Sciences of Ukraine», Kharkiv, Ukraine for surgical treatment for thymoma or carcinoma of the thymus gland. 102 people aged 18 to 69 with myasthenia have been comprehensively surveyed and their data have been analyzed and studied. Diagnosis of myasthenia was established according to the tenth edition of the International Classification of Diseases ICD-10 (WHO, 1992). Results: The severity of the patients’ condition corresponded to grade IIIA in 5 patients (16.7%), IIIB grade – 14 patients (46.7%), IVA grade – 7 patients (23.3%), IVB grade – in 4 patients (13.3%). According to the clinical classification of MGFA, the severity of the condition in most patients in this group corresponded to Class IIB (32.4%) and IIIA class (35.2%). Conclusions: The results of our study suggest that clinical and anamnestic features of myasthenia in absence of structural thymus disorders are debut before the age of 40 years, predominant affection of skeletal muscles, mild course (severity of the disease corresponds to 12.7 ± 1.76 points on the QMGS scale) and characterized by a debut after 40 years regardless of sex, manifestation of generalized muscle weakness and severe course (in 68.4% of cases severity of the disease was 31.68 ± 3.76 points on the QMGS scale).

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Advisability of Thymectomy in Young Patients With Thymus-Independent Myasthenia Gravis in the Presence of Biomarkers Specific for Patients With Thymoma

Cited by 3 publications

References 4 publications

Peculiarities of surgical tactics of patients with thymus tumors

Peculiarities of surgical tactics of patients with thymus tumors

Outcomes of surgical reconstruction of the superior vena cava syndrome in patients with locally advanced thymomas

Rehabilitation of the patients with myasthenia gravis as an Integral part of the patient’s Treatment Algorithm in the postoperative period

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