Affiliation:
1. Associate professor, Department of Cardio-Thoracic and Vascular surgery, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
2. Senior Resident, Department of Cardio-Thoracic and Vascular surgery, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
3. Senior Professor and Unit Head, Department of Cardio-Thoracic and Vascular surgery, SMS Medical College and Attached Group of Hospitals, Jaipur, Rajasthan, India
Abstract
Background: Thymectomy for widespread Myasthenia gravis may be associated with a turbulent
postoperative course especially if preoperative circulating acetylcholine receptor autoantibody levels
are towering. Plasmapheresis remove these antibodies. The aim of this study was to explore the results of preoperative
Plamapheresis on postoperative course after thymectomy. Material And Method This is a retrospective study at tertiary care
center where 13 patients of myasthenia gravis were operated in 3 year duration (2017-2020). All patients had undergone 2
cycles of plasmapheresis before surgery. Result was evaluated postoperatively in ICU, at the time of discharge, and at follow up
after 7 days, 1 month and 6 month in terms of weaning from ventilator, ICU stay, level of autoantibodies and length of hospital
stay, improvement in symptoms, and mortality. Results Out of 13 patients 5 (38.46%) were male and 8 (61.54%) were female in
the age range of 20 to 60 years. 6 (46.15%) were in stage IIA and 7 (53.85%) in stage IIB. Preoperative autoantibody levels were in
the range of 30-50 nmol/ml. Almost total thymectomy was done in all patients. Patients were extubated with in 4-6 hrs after
surgery and there was no mortality. Patients were discharged at postoperative day 4-7. Conclusion The study shows that
preoperative use of plasmapheresis to reduce the autoantibody level is associated with an early extubation, early discharge
and less complication after thymectomy.
Subject
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