21 重症肌无力外科治疗(1)
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• T-2 Videoscopic Thymectomy (a)- Classic VATS (b)- VATET
• T-3 Transsternal Thymectomy (a)- Standard (b)- Extended
• T-4 Transcervical & Transsternal Thymectomy
-- Mayo Clinic group 精品课件
精品课件
Crisis after themectomy
精品课件
Reoperation for thymus
精品课件
Future of surgical treatment
• “It seems likely that future discoveries will permit the management of myasthenia gravis without surgical intervention but, for the present, the beneficial role of thymectomy for these unfortunate patients has been clearly demonstrated.”
treatment
Ernst Ferdinand Sauerbruch (1875 –1951)
Alfred Blalock (1899 –1964)
精品Fra Baidu bibliotek件
Advance in surgical treatment
精品课件
MGFA classification of thymectomy
• T-1 Transcervical Thymectomy (a)- Basic (b)- Extended
• Time: preoperation evaluation and prepare
精品课件
How
• Range of resection • Thymectomy • Extended thymectomy • Maximal thymectomy
• Approach for surgery
• Transcervical • Transpleural • Transsternal
精品课件
Thymoma and myasthenia
gravis
Masaoka staging
Histological classification
精品课件
When
• Indication Thymectomy is recommended for those relatively
healthy patients whose myasthenic symptoms interfere with their lives enough for them to consider undergoing major thoracic surgery. While it is expensive and invasive,thymectomy is the only treatment available that offers a chance of an eventual drug-free remission. This chance seems to be better earlier in the disease than later. The potential benefit of thymectomy also decreases as the adult patient gets older and as the thymus naturally involutes with time. Further, the risk of surgery increases with age. The age at which the risks outweigh the potential benefits must be individualized for every patient
Surgical treatment of myasthenia gravis
精品课件
Background
• Description • Prevalence • Clinical presentation • Pathophysiology • Treatment
精品课件
Early practice in surgery
• T-3 Transsternal Thymectomy (a)- Standard (b)- Extended
• T-4 Transcervical & Transsternal Thymectomy
-- Mayo Clinic group 精品课件
精品课件
Crisis after themectomy
精品课件
Reoperation for thymus
精品课件
Future of surgical treatment
• “It seems likely that future discoveries will permit the management of myasthenia gravis without surgical intervention but, for the present, the beneficial role of thymectomy for these unfortunate patients has been clearly demonstrated.”
treatment
Ernst Ferdinand Sauerbruch (1875 –1951)
Alfred Blalock (1899 –1964)
精品Fra Baidu bibliotek件
Advance in surgical treatment
精品课件
MGFA classification of thymectomy
• T-1 Transcervical Thymectomy (a)- Basic (b)- Extended
• Time: preoperation evaluation and prepare
精品课件
How
• Range of resection • Thymectomy • Extended thymectomy • Maximal thymectomy
• Approach for surgery
• Transcervical • Transpleural • Transsternal
精品课件
Thymoma and myasthenia
gravis
Masaoka staging
Histological classification
精品课件
When
• Indication Thymectomy is recommended for those relatively
healthy patients whose myasthenic symptoms interfere with their lives enough for them to consider undergoing major thoracic surgery. While it is expensive and invasive,thymectomy is the only treatment available that offers a chance of an eventual drug-free remission. This chance seems to be better earlier in the disease than later. The potential benefit of thymectomy also decreases as the adult patient gets older and as the thymus naturally involutes with time. Further, the risk of surgery increases with age. The age at which the risks outweigh the potential benefits must be individualized for every patient
Surgical treatment of myasthenia gravis
精品课件
Background
• Description • Prevalence • Clinical presentation • Pathophysiology • Treatment
精品课件
Early practice in surgery