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Transsternal Maximal Thymectomy is Effective for Extirpation of Cervical Ectopic Thymic Tissue in the Treatment of Myasthenia Gravis

 Chang Young Lee  ;  Jin Gu Lee  ;  Woo Ik Yang  ;  Suk Jin Haam  ;  Kyung Young Chung  ;  In Kyu Park 
 YONSEI MEDICAL JOURNAL, Vol.49(6) : 987-992, 2008 
Journal Title
Issue Date
Adipose Tissue/pathology ; Adipose Tissue/surgery ; Adult ; Choristoma/pathology ; Choristoma/surgery ; Female ; Humans ; Male ; Middle Aged ; Myasthenia Gravis/surgery* ; Neck ; Retrospective Studies ; Thymectomy/methods* ; Thymus Gland ; Young Adult
Thymectomy ; myasthenia gravis
PURPOSE: Extensive extirpation of cervico-mediastinal adipose tissue increases the chance of removing ectopic thymic tissues, thus potentially improving the prognosis of myasthenia gravis after thymectomy. We sought to increase efficacy and safety of transsternal maximal thymectomy (TSMT). MATERIALS AND METHODS: Twenty four patients who underwent TSMT from July 2006 to June 2007 were retrospectively reviewed and compared with 73 patients who underwent transsternal extended thymectomy (TSET) from January 2004 to May 2006. Ectopic thymic tissue in additionally excised cervicomediastinal fat tissue was examined histologically. RESULTS: In TSMT group, operation time, amount of cumulative drainage and duration of drainage were significantly higher than TSET group. However, the difference in hemoglobin count, amount of transfusion, duration of intensive care, postoperative hospital stay, and complication rates were not statistically different. There was no operative mortality in either group. Ectopic thymic tissue was found in 50% of patients. All patients had ectopic thymic tissues in the cervical area. Two patients had additional ectopic tissue in the aortopulmonary window, and 1 patient had ectopic tissue at posterior of the left bracheocephalic vein and lateral of the right phrenic nerve. CONCLUSION: TSMT is more effective in the extirpation of ectopic thymic tissues than TSET without significant impairment of safety, especially in the cervical area.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Park, In Kyu(박인규)
Yang, Woo Ick(양우익) ORCID logo https://orcid.org/0000-0002-6084-5019
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
Haam, Seok Jin(함석진)
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