Mediastinoscopic extended thymectomy for pediatric patients with myasthenia gravis
| Autor: | F. Asano, S. Yamashita, H. Osaka, Kyoko Mochizuki, Norihiko Kitagawa, Masato Shinkai, Hiroshi Take, N. Kurauchi, Hisayuki Miyagi, T. Kido, H. Usui |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Microsurgery Adolescent Extended thymectomy Recurrent nerve Mediastinoscopy Blood loss Myasthenia Gravis medicine Humans Child medicine.diagnostic_test business.industry Infant General Medicine medicine.disease Thymectomy Myasthenia gravis Surgery Surgical access Dissection Treatment Outcome Anesthesia Child Preschool Pediatrics Perinatology and Child Health Dose reduction Female business |
| Zdroj: | Journal of pediatric surgery. 50(4) |
| ISSN: | 1531-5037 |
| Popis: | Background Extended thymectomy is indicated for children with myasthenia gravis (MG) when drug-resistance or dependence is seen. We have employed a technique for mediastinoscopic extended thymectomy (MET) on children with MG. Method A total of 14 children underwent MET at Kanagawa Children's Medical Center between 2005 and 2013. A mediastinal operation field was made by a V-shaped hook infrasternally to extirpate the thymus with adipose tissue around the thymus. Results The operation time and the amount of blood loss were 182±44minutes and 34±43ml, respectively. Postoperative complications, in the form of transient paralysis of the right recurrent nerve, occurred in 2 patients. The median length of postoperative hospital stay was 4.5days. After MET, 6 patients achieved complete remission and 7 patients achieved steroid dose reduction, but no improvement was seen in 1 patient. Conclusions This procedure offers the advantage of good surgical access for dissection around the bilateral phrenic nerves in extended total thymectomy, while achieving good cosmetic results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect