Open versus thoracoscopic thymectomy for juvenile myasthenia gravis

Derderian, S. Christopher; Potter, D. Dean; Bansal, Samiksha; Rowse, Phillip G.; Partrick, David A.

doi:10.1016/j.jpedsurg.2019.11.013

Cited by 11 publications

(9 citation statements)

References 25 publications

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“…Table 1 summarises the findings from the 17 studies. Some studies included both open and thoracoscopic thymectomy, often with express comparisons made [8,18,21,25,31], but sometimes without comparison [27].…”

Section: Resultsmentioning

confidence: 99%

“…It is difficult to quantify all symptoms within classifications, which can be subjective [18]. For example, head lifting and outstretching arms may assess less the severity of disease than the patient's will and prevailing mood [21].…”

Section: Resultsmentioning

confidence: 99%

“…between thoracoscopic and open approaches, but saw decreased intraoperative blood loss, decreased length of hospital stay, and improved cosmesis in the former [18]. Similarly, Goldstein et al (2015) found no difference in MGFA-QMG scores, or acetylcholinesterase inhibitor and steroid doses between the two approaches.…”

Section: Derderian Et Al (2020) Found No Difference In Clinical Improvement or Remissionmentioning

confidence: 93%

“…Historically, an open approach was favoured, which either included a median sternotomy, a transcervical incision, or both [18]. The thymus lies between the lower pole of the thyroid and the xiphisternum [32].…”

Section: On Surgical Approachmentioning

confidence: 99%

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Effectiveness of thymectomy in juvenile myasthenia gravis and clinical characteristics associated with better outcomes

Ng¹,

Hartley²

2021

Neuromuscular Disorders

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Derderian Et Al (2020) Found No Difference In Clinical Improvement or Remissionmentioning

confidence: 93%

Section: On Surgical Approachmentioning

confidence: 99%

See 2 more Smart Citations

Effectiveness of thymectomy in juvenile myasthenia gravis and clinical characteristics associated with better outcomes

Ng¹,

Hartley²

2021

Neuromuscular Disorders

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“…One of the most comprehensive systemic reviews showed that of 488 children with juvenile myasthenia gravis who underwent thymectomy, 70% had reduction in disease severity (17). Furthermore, the adaptation of minimally invasive thoracoscopic approaches has yielded favorable safety data compared to open surgery, although disease outcomes appear similar with both approaches (18,19). In this case, despite aggressive debulking, this patient continued to have disease progression post-thymectomy, possibly owing to his large tumor burden pre-operatively that did not respond to neoadjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of metastatic thymoma with prednisone in a patient with juvenile myasthenia gravis: a case report

Ramesh¹,

Velotta²

2022

Shanghai Chest

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Background: Juvenile myasthenia gravis is a rare autoimmune condition affecting children. Similar to myasthenia in adults, juvenile myasthenia gravis is associated with thymomas and many of these patients undergo thymectomy. However, there is no clear consensus on which patients could benefit from surgical intervention and how to manage refractory disease.Case Description: In this report, we describe a young boy who was diagnosed with myasthenia gravis and found to have stage IVa type B2 metastatic thymoma. Despite numerous pharmaceutical interventions, including neoadjuvant chemotherapy, his disease continued to progress. He ultimately underwent an extended radical parietal and visceral pleurectomy with decortication, total thymectomy, partial pericardial resection, and diaphragm resection and reconstruction. However, he had recurrence of his thymoma and was started on prednisone for palliative intent. Remarkably, within a few months he was noted to have interval decrease in his thoracic tumor burden and near resolution of his metastatic disease.Conclusions: Although spontaneous remission has been described in pediatric myasthenia, this report sheds light on possible management strategies post-thymectomy. This case additionally underscores the varied outcomes in patients treated for juvenile myasthenia gravis. Ultimately, this case, when added to both existing and future studies, will inform the development of guidelines on pediatric myasthenia gravis treatment.

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Surgical Incisions in Pediatric Surgical Oncology

Christison-Lagay

2024

Survival Handbook in Pediatric Surgical Oncology

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Open versus thoracoscopic thymectomy for juvenile myasthenia gravis

Cited by 11 publications

References 25 publications

Effectiveness of thymectomy in juvenile myasthenia gravis and clinical characteristics associated with better outcomes

Effectiveness of thymectomy in juvenile myasthenia gravis and clinical characteristics associated with better outcomes

Spontaneous resolution of metastatic thymoma with prednisone in a patient with juvenile myasthenia gravis: a case report

Surgical Incisions in Pediatric Surgical Oncology

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