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The Annals of Thoracic Surgery, Vol 45, 242-247, Copyright © 1988 by The Society of Thoracic Surgeons
JD Cooper, AN Al-Jilaihawa, FG Pearson, JG Humphrey and HE Humphrey
We have used the transcervical method of thymectomy in patients with
myasthenia gravis and believe that complete thymectomy is accomplished with
minimum morbidity. For the past eight years we have used an improved
technique for the transcervical approach, employing a specially designed
sternal retractor that permits improved visualization of the anterior
mediastinum. We have reviewed 65 patients operated on between 1977 and
1986. Patients were assessed using a modified Osserman classification (0 =
asymptomatic; 1 = ocular signs and symptoms; 2 = mild generalized weakness;
3 = moderate generalized weakness; 4 = severe generalized weakness,
respiratory dysfunction, or both). The mean grade for all patients at the
time of thymectomy was 2.7. At most recent follow-up, the mean clinical
grade was 0.5. In addition, 85% of patients were free of generalized
weakness, 95% had improved by at least one grade, and 86% had improved by
two or more grades. Comparing these results with those reported following
thymectomy through a sternotomy reveals that the transcervical approach
gives equivalent results.
ARTICLES
An improved technique to facilitate transcervical thymectomy for myasthenia gravis
Division of Thoracic Surgery and Neurology, Toronto General Hospital, Ont, Canada.
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