Thymectomy for myasthenia gravis: outcome of treatment in a tertiary hospital.
The clinical records of 24 of the 31 patients who underwent thymectomy for myasthenia gravis from January 1991 to December 1995 were reviewed. The mean age of patients was 36.5 years, with a male : female ratio of 1 : 5. The average duration of symptoms prior to consultation was 16.6 months. Most of the patients presented diplopia with clinical stage IIA prior to surgery. The most common procedure utilized was thymectomy via a median sternotomy under general anesthesia-epidural anesthesia. Five of the 24 patients (21%) were immediately extubated postoperatively while 19 remained intubated, with 12 patients attached to a ventilator. Extubation ranged from the first postoperative day up to more than two weeks postoperatively. The average length of ICU stay was 8.1 days and the average length of hospital stay was 31.1 days. The most common morbidity was pneumonia (38%). One patient had a brief reactive psychosis and another patient had phrenic nerve injury which manifested 2 weeks postoperatively. The average length of follow-up was 14.8 months and the mean follow-up period was 24.5 months. There was a general trend of decrease in the dose of medication. However, there was an increase in the medication in 3 patients with 2 showing clinical improvement.
Torres
M I
MI
Department of Surgery, UP College of Medicine-Philippine General Hospital, University of Philippines Manila, Taft Avenue, Manila 1004, Philippines.
Danguilan
J L
JL
D000293:Adolescent; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006769:Hospitals, General; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013934:Thymectomy; D016896:Treatment Outcome