Subject(s)
Biliary Fistula/surgery , Echinococcosis, Hepatic/complications , Echinococcosis/surgery , Enterococcus faecalis/isolation & purification , Liver Abscess/surgery , Postoperative Complications/surgery , Biliary Fistula/etiology , Biliary Fistula/physiopathology , Drainage/methods , Echinococcosis/etiology , Echinococcosis/physiopathology , Echinococcosis, Hepatic/diagnosis , Humans , Liver Abscess/microbiology , Liver Abscess/physiopathology , Magnetic Resonance Imaging , Male , Middle Aged , Postoperative Complications/microbiology , Postoperative Complications/physiopathology , Treatment OutcomeABSTRACT
Treatment results of 300 patients with myasthenia gravis (MG) were analyzed. 150 patients with MG and thymoma formed the main group, the rest 150 patients with non-thymomatous MG comprised the group of control. Thymomatous myasthenia was more severe and resistant to therapy. 79 (48.7%) patients had thymoma type B, mixed thymoma type AB was found in 45 (30.0%) patients, the rest had medullary tumors type A. I stage of the tumor progression was registered in 62.0% of cases, stage III was the second to find among them (20.0%). Long-term follow-up revealed stable and statistically proved improvement of MG clinic in patients of the main group (p=0.013). Survival rate of patients with thymoma and MG were 91.2, 83.4 and 72.3% after 3-, 5- and 10 years, correspondingly. Survival rates for non-thymomatous MG were significantly higher: 96.0, 91.6 and 87.2% after 3-,5- and 10 years, correspondingly. Tumor characteristics showed no influence on MG course after the operation. As well, as for the patients of the control group, only severity of the disease was the significant factor for the MG prognosis. Oncological prognosis was defined by pathomorphological type of thymoma and its progression stage. Thymomthymectomy allowed not only tumor remission but also myasthenia course stabilization and improvement.
Subject(s)
Myasthenia Gravis/surgery , Thymectomy/methods , Thymoma/surgery , Thymus Neoplasms/surgery , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Myasthenia Gravis/diagnosis , Myasthenia Gravis/etiology , Neoplasm Staging , Prognosis , Retrospective Studies , Severity of Illness Index , Thymoma/complications , Thymoma/diagnosis , Thymus Neoplasms/complications , Thymus Neoplasms/diagnosis , Time Factors , Young AdultABSTRACT
Results of diagnosis and treatment of 150 patients with thymoma and generalized myasthenia are analyzed. The results of examination were registered before surgery, and also in 1, 3, 5 and 10 years after one. It is demonstrated that thymoma is potentially malignant tumor with risk of recurrence and requires long follow-up of patient after operation. Morphologic type and stage of tumor, severity of myasthenia are the main predictors in the prognosis of surgical treatment. Thymomectomy with excision of fatty tissue of anterior mediastinum is absolutely indicated for this severe category of patients, and it decreases the risk of tumor progression. Mortality of patients depends not only on tumor growth or recurrence but also on concomitant myasthenic disorders.
Subject(s)
Myasthenia Gravis/surgery , Thymoma/surgery , Thymus Neoplasms/surgery , Adult , Female , Humans , Male , Middle Aged , Myasthenia Gravis/etiology , Survival Analysis , Thymoma/complications , Thymoma/diagnosis , Thymus Neoplasms/complications , Thymus Neoplasms/diagnosis , Treatment OutcomeABSTRACT
Forty-year experience with surgical treatment of generalized myasthenia (GM) based on 2977 cases is analyzed. Role of special methods of mediastinum examination (CT, MRT) is demonstrated, indications to thymectomy are validated. It is noted that developed diagnostic algorithm, surgical technique, management before and after surgery improved significantly immediate and long-term results. Development of clinical, immunological and morphologic criteria of thymectomy effect permitted to predict course of GM and to optimize complex therapy after surgical treatment.
