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Long-term outcome after thymectomy for myasthenia gravis and analysis of prognostic factors



Long-term outcome after thymectomy for myasthenia gravis and analysis of prognostic factors



Fudan Xuebao 33(6): 785-788,793



Purpose This paper tried to clarify the long-term outcome of thymectomy on myasthenia gravis(MG) and analyze the prognostic factors affecting surgical results. Methods We reviewed the data of 154 myasthenia gravis patients undergone thymectomy between Jan 1995 and Dec 1999. These patients' outcome and several clinical features including gender, age, pre-operation duration of MG, modified Osserman Classification, Besinger score, pathology of thymus, preoperative dose of prednisone, AchRab and PsmRab titer were evaluated by statistic method. Results The median follow-up period was 7.3 (5.3 - 10. 0) years. Two patients died during follow-up period. Among the survived 152 patients, 7. 9% (12/152) achieved complete remission, 76.3% (116/152) achieved patial remission, 7.9% (12/152) kept stable and 7. 9% (12/152) deteriorated at the last follow-up. The overall effective rate was 84.2%. Multivariate analysis showed Besinger score (regression coefficient= 0.057, P = 0. 020) and thymus histology( regression coefficient = - 1. 559, P 0. 012) were closely related to patients prognosis. Higher Besinger score or without thymoma predicated a favorate outcome. Conclusions Thymectomy is effective for most myasthenia gravis. Besinger score and pathology of thymus are potential prognostic factors for thymectomized myasthenia gravis. Further study should be carried out to confirm the relationship between modified osserman classification and prognosis.

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