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Preliminary results of VATS thymectomy for pediatric myasthenia gravis

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Abstract

Myasthenia gravis (MG) is a debilitating disease which necessitates long-term medical therapy. If left untreated, it can have a high mortality rate. The commonest variety in children, the autoimmune variety, often requires recourse to immunomodulation including prolonged usage of high-dose steroids. Thymectomy has not been a popular option among treating clinicians. There is evidence to suggest that if thymectomy is performed early in the disease, it has a high success rate in reducing the doses of the oral steroid medication and also in inducing remission of the disease. We have performed video-assisted thoracoscopic surgery (VATS) thymectomy in four patients with the autoimmune variety of MG. In this study, we have had a fair and comparable success rate as with the other adult series. On the basis of this preliminary study, we recommend that the option of VATS thymectomy should be offered to select patients of MG.

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References

  1. (2007) Nelson textbook of pediatrics. In: Kliegman (ed) Disorders of neuromuscular transmission and of motor neurons. 18th edn, Chap 611, Saunders, Philadelphia

  2. Sanders DB, Howard JF Jr (2008) Disorders of neuromuscular transmission. In: Bradley (ed) Neurology in clinical practice, 5th edn. Chap 82, pp 2383–2396

  3. Mineo TC, Pompeo E (2010) Extended videothoracoscopic thymectomy in nonthymomatous myasthenia gravis. Thorac Surg Clin 20(2):253–263

    Article  PubMed  Google Scholar 

  4. Magee MJ, Mack MJ (2009) Surgical approaches to the thymus in patients with myasthenia gravis. Thorac Surg Clin 19(1):83–89 (vii)

    Article  PubMed  Google Scholar 

  5. Kogut KA, Bufo AJ, Rothenberg SS, Lobe TE (2001) Thoracoscopic thymectomy for myasthenia gravis in children. Pediatr Endosurg Innovative Tech 5:113

    Google Scholar 

  6. Wolfe Gil I, Barohn Richard J (2006) Diseases of the neuromuscular junction. In: Swaiman KF, Ashwal S, Ferriero DM (eds) Pediatric neurology: principles and practice, edition 4, vol 2, Elsevier Health Sciences, pp 1941–1968

  7. Pompeo E, Tacconi F, Massa R, Mineo D, Nahmias S, Mineo TC (2009) Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. Eur J Cardiothorac Surg 36(1):164–169

    Article  PubMed  Google Scholar 

  8. Lin MW, Chang YL, Huang PM, Lee YC (2010) Thymectomy for non-thymomatous myasthenia gravis: a comparison of surgical methods and analysis of prognostic factors. Eur J Cardiothorac Surg 37(1):7–12

    Article  PubMed  Google Scholar 

  9. Tormoehlen LM, Pascuzzi RM (2008) Thymoma, myasthenia gravis, and other paraneoplastic syndromes. Hematol Oncol Clin North Am 22(3):509–526

    Article  PubMed  Google Scholar 

  10. Youssef SJ, Louie BE, Farivar AS, Blitz M, Aye RW, Vallières E (2010) Comparison of open and minimally invasive thymectomies at a single institution. Am J Surg 199(5):589–593

    Article  PubMed  Google Scholar 

  11. Komanapalli CB, Cohen JI, Sukumar MS (2010) Extended transcervical video-assisted thymectomy. Thorac Surg Clin 20(2):235–243

    Article  PubMed  Google Scholar 

  12. Ng CS, Wan IY, Yim AP (2010) Video-assisted thoracic surgery thymectomy: the better approach. Ann Thorac Surg 89(6):S2135–S2141

    Article  PubMed  Google Scholar 

  13. Meyer DM, Herbert MA, Sobhani NC, Tavakolian P, Duncan A, Bruns M, Korngut K, Williams J, Prince SL, Huber L, Wolfe GI, Mack MJ (2009) Comparative clinical outcomes of thymectomy for myasthenia gravis performed by extended transsternal and minimally invasive approaches. Ann Thorac Surg 87(2):385–390

    Article  PubMed  Google Scholar 

  14. Toolabi K, Aminian A, Javid MJ, Harirchian MH, Rabani A, Darabnia J (2009) Mid-term results of thoracoscopic thymectomy for myasthenia gravis. Neurol India 57(4):402–405

    Article  PubMed  Google Scholar 

  15. Ryniewicz B, Badurska B (1977) Follow-up study of myasthenic children after thymectomy. J Neurol 217:133–138

    Article  PubMed  CAS  Google Scholar 

  16. Loscertales J, Ayarra Jarne J, Congregado M, Arroyo Tristán A, Jiménez Merchán R, Girón Arjona JC, Linares CA (2004) Video-assisted thoracoscopic thymectomy for the treatment of myasthenia gravis. Arch Bronconeumol 40:409–413

  17. Kumar A, Kumar S, Ghanta R, Singh S, Pawar DK, Kalara V (2002) Thoracoscopic thymectomy for juvenile myasthenia gravis. Indian Pediatr (12):1131–1137

  18. Durkin ET, Shaaban AF (2008) Recent advances and controversies in pediatric laparoscopic surgery. Surg Clin N Am 88(5)

  19. Tracy MM (2009) Graded response to thymectomy in children with myasthenia gravis. J Child Neurol 24(4):454–459

    Article  PubMed  Google Scholar 

Download references

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Authors and Affiliations

  1. Tara Neo-Surg Hospital, C-5 Satyam Shopping Centre, MG Road, Ghatkopar (E), Mumbai, 400077, India

    Ketan Parikh, Amrish Vaidya & Rajesh Jain

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  1. Ketan Parikh
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  2. Amrish Vaidya
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  3. Rajesh Jain
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Correspondence to Ketan Parikh.

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Parikh, K., Vaidya, A. & Jain, R. Preliminary results of VATS thymectomy for pediatric myasthenia gravis. Pediatr Surg Int 27, 595–598 (2011). https://doi.org/10.1007/s00383-010-2838-4

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