La chirurgia della miastenia: procedure videoassistite


Adele Tessitore, Maria Letizia Vita, Giacomo Cusumano, Maria Teresa Congedo, Mariella Filotico, Elisa Meacci, Venanzio Porziella, Stefano Margaritora, Pierluigi Granone

Ann. Ital. Chir., 2007; 78: 355-358

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OBJECTIVE: We describe the technique, the benefits and the drawbacks of an original video-assisted thymectomy (VAT),
performed through an inframammary cosmetic incision and median sternotomy in myasthenia gravis (MG) patients.
This procedure is clinically valuable and cosmetically satisfactory so as to be very well accepted by patients, especially by
young women. Minimal-access thymectomy has become increasingly popular as surgical treatment for patients with nonthymomatous
myasthenia gravis because of its comparable efficacy, safety, and lesser degree of tissue trauma with conventional
open surgery.
METHODS: We report a review/interview of 180 MG patients treated between 1993 and 2005. According to Myasthenia
Gravis Foundation of America (MGFA), complete stable remission (CSR) and pharmacologic remission (PR) were calculated
at the end of a minimal period of 12 months.
RESULTS: A clinical remission was obtained in 41.1% (CR 27.8%, PR 13.3%), who had been followed for at least
12 months from surgery. 95% of these patients judged their cosmetic results to be excellent or good.
CONCLUSIONS: Thymectomy in MG video-assisted infra-mammary cosmetic incision has shown to be a useful surgical
approach as demonstrated by the good functional and very good aesthetic results, associated with a very low morbidity
and no mortality.


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