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Thymectomy in the Management of juvenile myasthenia gravis

Mariem Hadj Dahmane, mahdi Abdennadher, WIFEK SAIDANI, Hazem Zribi, Sarra Zairi, Imen Bouassida, Sonia Ouerghi, Adel Marghli
European Respiratory Journal 2021 58: PA3420; DOI: 10.1183/13993003.congress-2021.PA3420
Mariem Hadj Dahmane
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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  • For correspondence: mariamhadj@gmail.com
mahdi Abdennadher
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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WIFEK SAIDANI
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Hazem Zribi
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Sarra Zairi
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Imen Bouassida
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Sonia Ouerghi
2ANESTHESY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Adel Marghli
1THORACIC AND CARDIOVASCULAR SURGERY DEPARTMENT ABDERRAHMEN MAMI TUNISIA, ARIANA, Tunisia
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Abstract

Introduction: Thymectomy provides a good opportunity for improvement in symptoms of selected children with myasthenia gravis and may be attended with a low risk of mortality.

Methods: Were retrospectively reviewed 14 children under 20 years who underwent thymectomy for myasthenia gravis between 1996 and 2020 in the Thoracic Surgery Department in Abderrahmane mami Hospital, Tunisia.

Results: There were 3 boys and 11 girls, with a mean age of 15.7 years (9–19 years). Ten children (71%) were operated on through a minimally invasive thoracic surgery approach. Six (60%) patients underwent thymectomy by video thoracoscopic, while 04 (20%) patients underwent thymectomy by video-assisted thoracoscopic surgery. Open thymectomy via median sternotomy (MS) was performed in 4 patients (29%); in two cases, the thymoma was locally advanced and invaded nearby structures, in the other two cases MS was performed because of the tumor size (7-9cm). Of the 14 patients, total thymectomy was performed in 10 cases, it was combined with mediastinal grease resection in 3 cases, and combined with atypical lung resection in 1 case. Two patients experienced postoperative complications. One patient suffered a myasthinic crisis, another had a postoperative chylothorax, one month later. There were no postoperative mortalities. Pathologic examination revealed thymic hyperplasia in 12 cases (85%) and thymoma in 2 cases (15%) which was classified as B3 stage II and AB stage I. After a mean follow-up period of 3 years, 12 of 14 patients were entirely off medication.

Conclusion: Complete thymic resection appears to be a safe intervention with few postoperative complications. Patients demonstrated a significant improvement compared to their pre-operative presentation.

  • Treatments
  • Children
  • Mediastinal tumour

Footnotes

Cite this article as: European Respiratory Journal 2021; 58: Suppl. 65, PA3420.

This abstract was presented at the 2021 ERS International Congress, in session “Prediction of exacerbations in patients with COPD”.

This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).

  • Copyright ©the authors 2021
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Thymectomy in the Management of juvenile myasthenia gravis
Mariem Hadj Dahmane, mahdi Abdennadher, WIFEK SAIDANI, Hazem Zribi, Sarra Zairi, Imen Bouassida, Sonia Ouerghi, Adel Marghli
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3420; DOI: 10.1183/13993003.congress-2021.PA3420

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Thymectomy in the Management of juvenile myasthenia gravis
Mariem Hadj Dahmane, mahdi Abdennadher, WIFEK SAIDANI, Hazem Zribi, Sarra Zairi, Imen Bouassida, Sonia Ouerghi, Adel Marghli
European Respiratory Journal Sep 2021, 58 (suppl 65) PA3420; DOI: 10.1183/13993003.congress-2021.PA3420
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