Universität zu Köln

Menghesha, Hruy, Schroeter, Michael, Doerr, Fabian, Schlachtenberger, Georg, Heldwein, Matthias B., Chiapponi, Costanza ORCID: 0000-0002-4681-2835, Wahlers, Thorsten, Bruns, Christiane and Hekmat, Khosro (2022). The value of thymectomy in the treatment of non-thymomatous myasthenia gravis. Chirurg, 93 (1). S. 48 - 56. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1433-0385

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Abstract

The value of thymectomy in the treatment of non-thymomatous myasthenia gravis has been controversially discussed. The relatively low incidence and prevalence of this disease, the inconsistent documentation in various studies and the necessity of a long-term follow-up to assess the therapeutic effects has made the generation of valid data difficult. The publication in 2016 of the MGTX trial in the New England Journal of Medicine delivered the first randomized controlled data in which patients aged 18-65 years with generalized myasthenia gravis and positive for acetylcholine receptor antibodies showed a significant benefit after surgical resection of the thymus via median sternotomy. Despite a lack of validation of the advantages of thymectomy by minimally invasive surgery from randomized controlled studies, this technique seems to positively influence the outcome of certain patient groups in a similar way. Video-assisted thoracoscopic surgery (VATS) and robotic-assisted thoracic surgery (RATS) using subxyphoidal and transcervical access routes showed not only esthetic advantages but also showed no relevant inferiority in the influence on clinical outcomes of myasthenia gravis compared to median sternotomy; however, not only the benefits and the esthetic results show differences but also the advantages in the various subtypes of myasthenia gravis show divergent prospects of success with respect to remission. The clinical spectrum of myasthenia is heterogeneous with respect to the occurrence of antibodies, the body region affected and the age of the patient at first diagnosis. Ultimately, thymectomy is an effective causal treatment of myasthenia gravis.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Menghesha, Hruy UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeter, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Doerr, Fabian UNSPECIFIED UNSPECIFIED UNSPECIFIED Schlachtenberger, Georg UNSPECIFIED UNSPECIFIED UNSPECIFIED Heldwein, Matthias B. UNSPECIFIED UNSPECIFIED UNSPECIFIED Chiapponi, Costanza UNSPECIFIED orcid.org/0000-0002-4681-2835 UNSPECIFIED Wahlers, Thorsten UNSPECIFIED UNSPECIFIED UNSPECIFIED Bruns, Christiane UNSPECIFIED UNSPECIFIED UNSPECIFIED Hekmat, Khosro UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-563611
DOI:	10.1007/s00104-021-01436-3
Journal or Publication Title:	Chirurg
Volume:	93
Number:	1
Page Range:	S. 48 - 56
Date:	2022
Publisher:	SPRINGER HEIDELBERG
Place of Publication:	HEIDELBERG
ISSN:	1433-0385
Language:	German
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TRANS-CERVICAL THYMECTOMY; ECTOPIC THYMIC TISSUE; EXTENDED THYMECTOMY; MAXIMAL THYMECTOMY; OCULAR MYASTHENIA; REPEAT THYMECTOMY; EFFICACY; OUTCOMES; SAFETY Multiple languages Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/56361