Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?

Roth, T.; Ackermann, R.; Stein, R.; Inderbitzi, R.; Rösler, K.; Schmid, R.A. (2002). Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome? European journal of cardio-thoracic surgery, 21(4), pp. 664-670. Elsevier Science B.V. 10.1016/S1010-7940(02)00031-3

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Objective: Long-term evaluation of efficacy and quality of life after radical surgical approach for myasthenia gravis (MG). Comparison between short-term follow-up and long-term outcome. Methods: All patients (n=26, 16 men and 10 women, mean age: 40.7 years) underwent total transsternal thymectomy for MG between 1986 and 1989. Prospective analysis of the patients for short-term follow-up (mean 22.4 months) was published in 1991. The same group of patients was reevaluated in 2001 (range of follow-up 11.4–15.2 years) and assessed according to the classification of Osserman and Oosterhuis. Results: Mean follow-up was 13.0 years (range 11.4–15.2 years). Two patients were lost from follow-up and one died 4 years after thymectomy for reasons unrelated to MG (n=23). No early or late postoperative mortality was observed. One sternal osteomyelitis occurred. Late postoperative morbidity included sternal instabilities (n=2), mild residual thoracic pain (n=6), and hypertrophic scars (n=7). Five patients were rehospitalized for aggravating MG and needed plasmapheresis (n=3) and intubation (n=1). Thirteen patients (56.5%) showed objective clinical improvement, including six patients (26.1%) with complete remission. Eleven patients (47.8%) do not take any medication at all. Because some late relapse may occur several years after operation, the rate of improvement decreased slightly, whereas the difference between short and long-term follow-up was not statistically significant (P=0.405). Twenty patients (87%) returned to work, including part-time occupation (n=4). Fourteen patients (61%) are performing sports regularly. Conclusions: Our data confirm that radical, transsternal thymectomy is an effective and safe therapeutic modality for MG. Short-term results seem to deteriorate over time, therefore long-term studies for minimally invasive approaches have to prove equal results before replacing the standard procedure.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gastro-intestinal, Liver and Lung Disorders (DMLL) > Clinic of Thoracic Surgery
04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology

UniBE Contributor:

Stein, Robert; Rösler, Kai Michael and Schmid, Ralph

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1010-7940

Publisher:

Elsevier Science B.V.

Language:

English

Submitter:

Marceline Brodmann

Date Deposited:

07 Oct 2020 14:02

Last Modified:

07 Oct 2020 14:15

Publisher DOI:

10.1016/S1010-7940(02)00031-3

Related URLs:

BORIS DOI:

10.7892/boris.116016

URI:

https://boris.unibe.ch/id/eprint/116016

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