Improved procedures and comparative results for video-assisted thoracoscopic extended thymectomy for myasthenia gravis
Introduction We previously introduced video-assisted thoracoscopic ET (VATS-ET) as a therapeutic option for MG with acceptable results. We have conducted further investigations to improve the procedure without deterioration of operative results, including myasthenia gravis (MG) remission rate and pa...
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| Veröffentlicht in: | Surgical endoscopy 2015-09, Vol.29 (9), p.2859-2865 |
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| creator | Nakagiri, Tomoyuki Inoue, Masayoshi Shintani, Yasushi Funaki, Soichiro Kawamura, Tomohiro Minami, Masato Ohta, Mitsunori Kadota, Yoshihisa Shiono, Hiroyuki Okumura, Meinoshin |
| description | Introduction
We previously introduced video-assisted thoracoscopic ET (VATS-ET) as a therapeutic option for MG with acceptable results. We have conducted further investigations to improve the procedure without deterioration of operative results, including myasthenia gravis (MG) remission rate and palliation rate. Here, we report the details of our current procedure, as well as surgical results and patient outcomes as compared with the original VATS-ET procedure.
Material and methods
From January 2002 to September 2013, we performed a VATS-ET procedure with an anterior chest wall lifting method for 77 patients who had MG with or without a thymoma. During that period, we investigated the appropriate indications and improved the procedure.
Results
Our current indication for this procedure is MG with the anti-acetylcholine receptor antibody or sero-negative type, or MG with a thymoma |
| doi_str_mv | 10.1007/s00464-014-3964-1 |
| format | Article |
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We previously introduced video-assisted thoracoscopic ET (VATS-ET) as a therapeutic option for MG with acceptable results. We have conducted further investigations to improve the procedure without deterioration of operative results, including myasthenia gravis (MG) remission rate and palliation rate. Here, we report the details of our current procedure, as well as surgical results and patient outcomes as compared with the original VATS-ET procedure.
Material and methods
From January 2002 to September 2013, we performed a VATS-ET procedure with an anterior chest wall lifting method for 77 patients who had MG with or without a thymoma. During that period, we investigated the appropriate indications and improved the procedure.
Results
Our current indication for this procedure is MG with the anti-acetylcholine receptor antibody or sero-negative type, or MG with a thymoma <5 cm in diameter without invasion to adjacent organs. With our procedure, the thymus and surrounding tissue are sufficiently resected using a bilateral thoracoscopic surgical method without neck incision. Remission and palliation rates were found to be equivalent to those obtained with the original VATS-ET procedure.
Conclusion
VATS-ET is suitable for select patients with MG with or without a thymoma. In addition, our current method has shown to be effective while also offering cosmetic advantages as compared with the original, neck incision needed, VATS-ET method.</description><identifier>ISSN: 0930-2794</identifier><identifier>EISSN: 1432-2218</identifier><identifier>DOI: 10.1007/s00464-014-3964-1</identifier><identifier>PMID: 25487544</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Abdominal Surgery ; Adolescent ; Adult ; Aged ; Clinical outcomes ; Female ; Gastroenterology ; Gynecology ; Hepatology ; Humans ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Myasthenia gravis ; Myasthenia Gravis - complications ; Myasthenia Gravis - surgery ; Patients ; Proctology ; Surgery ; Technique ; Thoracic surgery ; Thoracic Surgery, Video-Assisted - methods ; Thymectomy - methods ; Thymoma - complications ; Thymoma - surgery ; Thymus gland ; Treatment Outcome ; Young Adult</subject><ispartof>Surgical endoscopy, 2015-09, Vol.29 (9), p.2859-2865</ispartof><rights>Springer Science+Business Media New York 2014</rights><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-213e1cfd662a2aee7ae164708364484037e361fef60619b32d2c313027e364cc3</citedby><cites>FETCH-LOGICAL-c471t-213e1cfd662a2aee7ae164708364484037e361fef60619b32d2c313027e364cc3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00464-014-3964-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00464-014-3964-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25487544$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nakagiri, Tomoyuki</creatorcontrib><creatorcontrib>Inoue, Masayoshi</creatorcontrib><creatorcontrib>Shintani, Yasushi</creatorcontrib><creatorcontrib>Funaki, Soichiro</creatorcontrib><creatorcontrib>Kawamura, Tomohiro</creatorcontrib><creatorcontrib>Minami, Masato</creatorcontrib><creatorcontrib>Ohta, Mitsunori</creatorcontrib><creatorcontrib>Kadota, Yoshihisa</creatorcontrib><creatorcontrib>Shiono, Hiroyuki</creatorcontrib><creatorcontrib>Okumura, Meinoshin</creatorcontrib><title>Improved procedures and comparative results for video-assisted thoracoscopic extended thymectomy for myasthenia gravis</title><title>Surgical endoscopy</title><addtitle>Surg Endosc</addtitle><addtitle>Surg Endosc</addtitle><description>Introduction
We previously introduced video-assisted thoracoscopic ET (VATS-ET) as a therapeutic option for MG with acceptable results. We have conducted further investigations to improve the procedure without deterioration of operative results, including myasthenia gravis (MG) remission rate and palliation rate. Here, we report the details of our current procedure, as well as surgical results and patient outcomes as compared with the original VATS-ET procedure.
Material and methods
From January 2002 to September 2013, we performed a VATS-ET procedure with an anterior chest wall lifting method for 77 patients who had MG with or without a thymoma. During that period, we investigated the appropriate indications and improved the procedure.
Results
Our current indication for this procedure is MG with the anti-acetylcholine receptor antibody or sero-negative type, or MG with a thymoma <5 cm in diameter without invasion to adjacent organs. With our procedure, the thymus and surrounding tissue are sufficiently resected using a bilateral thoracoscopic surgical method without neck incision. Remission and palliation rates were found to be equivalent to those obtained with the original VATS-ET procedure.
Conclusion
VATS-ET is suitable for select patients with MG with or without a thymoma. In addition, our current method has shown to be effective while also offering cosmetic advantages as compared with the original, neck incision needed, VATS-ET method.</description><subject>Abdominal Surgery</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Clinical outcomes</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Gynecology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Myasthenia gravis</subject><subject>Myasthenia Gravis - complications</subject><subject>Myasthenia Gravis - surgery</subject><subject>Patients</subject><subject>Proctology</subject><subject>Surgery</subject><subject>Technique</subject><subject>Thoracic surgery</subject><subject>Thoracic Surgery, Video-Assisted - methods</subject><subject>Thymectomy - methods</subject><subject>Thymoma - complications</subject><subject>Thymoma - surgery</subject><subject>Thymus gland</subject><subject>Treatment Outcome</subject><subject>Young Adult</subject><issn>0930-2794</issn><issn>1432-2218</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkUFr3DAQhUVoSTZpf0AvxZBLLm5nJNmyjyUkaSDQS3sWijxOHNbWViOb7L-PdjctpVB6GvH0vTcMT4gPCJ8QwHxmAF3rElCXqs0PPBIr1EqWUmLzRqygVVBK0-oTccr8BBlvsToWJ7LSjam0XonldtzEsFBX5OGpmyNx4aau8GHcuOjSsFCRtXmduOhDLJaho1A65oFTdqXHEJ0P7MNm8AU9J5q6vbwdyacwbvemces4PdI0uOIhumXgd-Jt79ZM71_nmfhxffX98mt59-3m9vLLXem1wVRKVIS-7-paOumIjCOstYFG1Vo3GpQhVWNPfQ01tvdKdtIrVCB3uvZenYmLQ26-7udMnOw4sKf12k0UZrbYVK02VaP0_1EDlZEtNJDR87_QpzDHKR-ypzTk2CZTeKB8DMyReruJw-ji1iLYXX_20J_N_dldfxaz5-Nr8nw_Uvfb8auwDMgDwPlreqD4x-p_pr4AmJamkw</recordid><startdate>20150901</startdate><enddate>20150901</enddate><creator>Nakagiri, Tomoyuki</creator><creator>Inoue, Masayoshi</creator><creator>Shintani, Yasushi</creator><creator>Funaki, Soichiro</creator><creator>Kawamura, Tomohiro</creator><creator>Minami, Masato</creator><creator>Ohta, Mitsunori</creator><creator>Kadota, Yoshihisa</creator><creator>Shiono, Hiroyuki</creator><creator>Okumura, Meinoshin</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>7TK</scope></search><sort><creationdate>20150901</creationdate><title>Improved procedures and comparative results for video-assisted thoracoscopic extended thymectomy for myasthenia gravis</title><author>Nakagiri, Tomoyuki ; Inoue, Masayoshi ; Shintani, Yasushi ; Funaki, Soichiro ; Kawamura, Tomohiro ; Minami, Masato ; Ohta, Mitsunori ; Kadota, Yoshihisa ; Shiono, Hiroyuki ; Okumura, Meinoshin</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-213e1cfd662a2aee7ae164708364484037e361fef60619b32d2c313027e364cc3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Abdominal Surgery</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Clinical outcomes</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Gynecology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Myasthenia gravis</topic><topic>Myasthenia Gravis - complications</topic><topic>Myasthenia Gravis - surgery</topic><topic>Patients</topic><topic>Proctology</topic><topic>Surgery</topic><topic>Technique</topic><topic>Thoracic surgery</topic><topic>Thoracic Surgery, Video-Assisted - methods</topic><topic>Thymectomy - methods</topic><topic>Thymoma - complications</topic><topic>Thymoma - surgery</topic><topic>Thymus gland</topic><topic>Treatment Outcome</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nakagiri, Tomoyuki</creatorcontrib><creatorcontrib>Inoue, Masayoshi</creatorcontrib><creatorcontrib>Shintani, Yasushi</creatorcontrib><creatorcontrib>Funaki, Soichiro</creatorcontrib><creatorcontrib>Kawamura, Tomohiro</creatorcontrib><creatorcontrib>Minami, Masato</creatorcontrib><creatorcontrib>Ohta, Mitsunori</creatorcontrib><creatorcontrib>Kadota, Yoshihisa</creatorcontrib><creatorcontrib>Shiono, Hiroyuki</creatorcontrib><creatorcontrib>Okumura, Meinoshin</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Neurosciences Abstracts</collection><jtitle>Surgical endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nakagiri, Tomoyuki</au><au>Inoue, Masayoshi</au><au>Shintani, Yasushi</au><au>Funaki, Soichiro</au><au>Kawamura, Tomohiro</au><au>Minami, Masato</au><au>Ohta, Mitsunori</au><au>Kadota, Yoshihisa</au><au>Shiono, Hiroyuki</au><au>Okumura, Meinoshin</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Improved procedures and comparative results for video-assisted thoracoscopic extended thymectomy for myasthenia gravis</atitle><jtitle>Surgical endoscopy</jtitle><stitle>Surg Endosc</stitle><addtitle>Surg Endosc</addtitle><date>2015-09-01</date><risdate>2015</risdate><volume>29</volume><issue>9</issue><spage>2859</spage><epage>2865</epage><pages>2859-2865</pages><issn>0930-2794</issn><eissn>1432-2218</eissn><abstract>Introduction
We previously introduced video-assisted thoracoscopic ET (VATS-ET) as a therapeutic option for MG with acceptable results. We have conducted further investigations to improve the procedure without deterioration of operative results, including myasthenia gravis (MG) remission rate and palliation rate. Here, we report the details of our current procedure, as well as surgical results and patient outcomes as compared with the original VATS-ET procedure.
Material and methods
From January 2002 to September 2013, we performed a VATS-ET procedure with an anterior chest wall lifting method for 77 patients who had MG with or without a thymoma. During that period, we investigated the appropriate indications and improved the procedure.
Results
Our current indication for this procedure is MG with the anti-acetylcholine receptor antibody or sero-negative type, or MG with a thymoma <5 cm in diameter without invasion to adjacent organs. With our procedure, the thymus and surrounding tissue are sufficiently resected using a bilateral thoracoscopic surgical method without neck incision. Remission and palliation rates were found to be equivalent to those obtained with the original VATS-ET procedure.
Conclusion
VATS-ET is suitable for select patients with MG with or without a thymoma. In addition, our current method has shown to be effective while also offering cosmetic advantages as compared with the original, neck incision needed, VATS-ET method.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>25487544</pmid><doi>10.1007/s00464-014-3964-1</doi><tpages>7</tpages></addata></record> |
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| subjects | Abdominal Surgery Adolescent Adult Aged Clinical outcomes Female Gastroenterology Gynecology Hepatology Humans Male Medicine Medicine & Public Health Middle Aged Myasthenia gravis Myasthenia Gravis - complications Myasthenia Gravis - surgery Patients Proctology Surgery Technique Thoracic surgery Thoracic Surgery, Video-Assisted - methods Thymectomy - methods Thymoma - complications Thymoma - surgery Thymus gland Treatment Outcome Young Adult |
| title | Improved procedures and comparative results for video-assisted thoracoscopic extended thymectomy for myasthenia gravis |
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