ISSN : 1301-5680
e-ISSN : 2149-8156
Turkish Journal of Thoracic and Cardiovascular Surgery     
Could preoperative medication in myasthenia gravis be a cause of the complications following transsternal thymectomy?
Alper Toker1, Türkan Tansel2, Ufuk Alpagut2, Serhan Tanju1, Şükrü Dilege1, Enver Dayıoğlu2, Ertan Onursal2
1Departments of General Thoracic Surgery İstanbul Medicine Faculty of İstanbul University, İstanbul
2Departments of Cardiovascular Surgery, İstanbul Medicine Faculty of İstanbul University, İstanbul
Background: Complications after transsternal thymectomy for myasthenia gravis were considered to be a major problem. This study was designed to assess the relation between preoperative medication and complications.

Methods: The study group consists of 229 myasthenia gravis patients without thymoma, (164 females, 65 males; mean age 35.6 years; range 9 to 70 years). Postoperative complications and relations with age, gender, duration of symptoms, the clinical stage of the disease, the type of the operative procedure and medication were analyzed. The study population was divided into five groups according to their preoperative medication. Group 1 (n=51) Cholinesterase inhibitors, group 2 (n=30) Corticosteroids, group 3 (n=125) Cholinesterase inhibitors and Corticosteroids, group 4 (n=13) Immunosuppressants, Cholinesterase inhibitors and Corticosteroids, and group 5 (n=10) No medication. Postoperative complications were: i) Infectious complications (n=18), ii) Myasthenic complications (n=14), and iii) Others (n=7).

Results: There was not any statistically significant relation between complications and analyzed data other than subgroup of medications. Patients who had cholinesterase inhibitors, immunosuppressive therapy with additional corticosteroids had increased number of complications (p=0.004).

Conclusion: Concomitant administration of immunusupressants, cholinesterase inhibitors and corticosteroids to patients with Myasthenia Gravis could increase the number of complications following transsternal thymectomy.

Keywords : Myasthenia Gravis/surgery; thymectomy/methods
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