History of surgical treatment of myasthenia gravis

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The earliest evidence of effective surgical treatment of myasthenia gravis dates back to 1901, CarlWeigert (Figure 15-1A) for the first time

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The earliest evidence of effective surgical treatment of myasthenia gravis dates back to 1901, Carl

Weigert (Figure 15-1A) for the first time presented the relationship between thymus and myasthenia gravis (Carl et al 1901). 1912, Ernst

Ferdinand Saubruch (15-1B) 20 year old woman reported 1 cases of hyperthyroidism complicated with myasthenia gravis patients, resection of the thymus hyperplasia after patients with myasthenia gravis symptoms significantly improved, which is of thymectomy for myasthenia gravis reported in the literature about the earliest (Saubruch

Et al 1912). 1936, Alfred

Blalock (Figure 15-1C) report summarized the treatment of myasthenia gravis thymus resection experience in 20 cases, this paper is a retrospective study on surgical treatment of myasthenia gravis first clinical system, is of epoch-making significance. Since then, after a hundred years of development, thymectomy has become one of the main means of treatment of myasthenia gravis.

With the wide application of thymectomy in treatment of myasthenia gravis, for thymectomy in myasthenia gravis patients instability, if indeed there is a higher remission rate, what are the influencing factors of problem has been discussed and research hotspot. For example, although thymectomy method has changed from the early simple thymectomy (Thymectomy), to develop and expand the scope of thymectomy (Extended Thymectomy), the maximum range of thymus resection (Maximal Thymectomy), resection of video-assisted thymus (VATS Thymectomy) and other models, but the study of the relationship between the efficacy of surgical patients around gender, age at surgery, surgery the duration of disease, clinical type and thymus pathological factors and postoperative were not affirmed and consistent results, there are still many disputes. In addition, some key questions, such as how to choose the right surgical patients, preoperative preparation, how to determine the timing of surgery, and how to implement the best perioperative management are still no answer. The main cause has been controversial is because most of the existing studies were retrospectively analyzed, the lack of large sample system of prospective studies or prospective randomized stratified study to confirm, therefore also led to thymectomy could not make a systematic and comprehensive evaluation and understanding, it is impossible for all thymectomy techniques and methods were compared and analyzed objectively.

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