Вибір Тактики Лікування Хворих На Міастенію Різного Віку В Залежності Від Показників Імунорезистентності

Бойко, В В; Клімова, О. М.; Lavinska, O. V.; Drozdova, L. A.; Minukhin, D. V.; Євтушенко, Д. О.

doi:10.26697/ijes.2019.3.4

Cited by 2 publications

(1 citation statement)

References 3 publications

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“…The first reliable description of the clinical profile of SVCS was provided by W. Hunter (1757) [8,9]. Further numerous works of foreign and Ukrainian authors considerably expanded the understanding of the origin of this syndrome; however, surgical treatment methods were not used until the middle or end of the previous century.…”

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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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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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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Вибір Тактики Лікування Хворих На Міастенію Різного Віку В Залежності Від Показників Імунорезистентності

Cited by 2 publications

References 3 publications

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

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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