Surgical results of video-assisted thoracoscopic thymectomy for treatment of Juvenile Myasthenia Gravis
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Date
2021
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Abstract
Juvenile myasthenia gravis (JMG) is an autoimmune disease affecting the neuromuscular junction that appears before 19 years of age with varying degrees of weakness of different muscle groups. The main treatment is pharmacological, but thymectomy has also demonstrated to improve remission rates. Objective: To describe the clinical characteristics and postoperative course of pediatric patients with JMG who underwent video-assisted thoracoscopic (VATS) thymectomy. Clinical Serie: Six patients who underwent VATS thymectomy between March 2011 and June 2019. The age range at diagnosis was between 2 and 14 years and the average age at surgery was 7 years. All patients were under treatment with pyridostigmine bromide associated with immunosuppression with corticosteroids before surgery. The interval between diagnosis and thymectomy was 21.5 months on average. VATS was performed by left approach, and there was no perioperative morbidity or mortality. The average hospital stay was 2 days. Three patients remain with no symptoms and without corticotherapy. Two patients were on corticosteroids, but in smaller doses than previous to surgery. One patient presented a crisis requiring hospitalization and ventilatory support during follow-up. Conclusion: VATS thymectomy is part of the treatment for JMG. In this series, it appears as a safe approach and its results were favorable.
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Keywords
Myasthenia Gravis, Thymus, Thymectomy, VATS, Video-assisted thoracoscopy