ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the clinical characteristics and long-term outcome of 310 cases of thymectomy for myasthenia Gravis.</p><p><b>METHODS</b>The data of 310 patients with thymectomy were analyzed retrospectively to study the patient selection, operative techniques, perioperative management and results for myasthenia Gravis. Absolute and relative scores for clinical evaluation were used as the criteria to determine the therapeutic effects of thymectomy.</p><p><b>RESULTS</b>There were no operative death and postoperative complication rates were 8.7% (27/310). The extra anatomic thymic tissue was found in up to 38.7% (120/310) patients and thymus hyperplasia occurred in 92.9% (288/310) cases. 92.6% (287/310) postoperative patients were followed up for 3 or more months; the percentage of patients being remitted, essentially remitted, significantly effective, effective and non-effective were 7.1% (22/310), 11.3% (35/310) 40.0% (124/310), 27.1% (84/310), 7.1% (22/310) respectively. The total long-term effective rate was 85.5% (265/310). The effective rate for type I, IIa, IIb, III, IV was 90.9% (20/22), 97.6% (40/41), 95.3% (162/170), 80.6% (29/36), 77.8% (14/18) respectively.</p><p><b>CONCLUSIONS</b>Generalized typed and properly selected recurrent ocular-typed patients with Myasthenia Gravis undergoing extensive thymectomy would have good long-term outcomes.</p>
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Young Adult , Follow-Up Studies , Myasthenia Gravis , General Surgery , Perioperative Care , Prognosis , Retrospective Studies , Thymectomy , Methods , Treatment OutcomeABSTRACT
Objective To compare the influences of off-pump and on-pump coronary artery bypass grafting operation on plasma thyroid hormones.Methods Forty patients undergoing coronary surgery were randomly divided into off-pump group(n=20)and on- pump group(n=20).Plasma thyroid hormones(T_3,T_4,FT_3,FT_4,rT_3)and thyroid-stimulating hormone(TSH)were studied perio- peratively.Results Before operation,the values of aU the variables were within normal range in the two groups.In off-pump group, T_3 and FT_3 concentration dropped significantly after operation,reaching the lowest value at first day postoperatively[T_3:(39.7?6.2) ng/dl vs.(78.6?2.1)ng/dl,P0.05),which were within normal range all along,rT_3 concentration rose significantly after operation,reaching the highest value at third day postoperatively[(82.1?26.8)ng/dl vs.(42.3?15.6)ng/dl, P0.05),whereas baseline,operative and postoperative variables were similar.Con- clusion Off-pump operation has some influences on plasma thyroid hormones,showing"low T_3 syndrome"postoperatively,that is similar to what on-pump operation does.