Thymectomy is one of the current management strategies for @entity1737 . This is observational study focused on the evolution of the surgical and anesthesiological strategies applied to the @entity1 submitted to thymectomy initially by maximal sternotomy (in the years 1994-1998), followed by unconditioned reorientation towards thymectomy by VATS. A number of 103 @entity1 are included, 51 thymectomy by left VATS. All the thoracoscopic thymectomy were performed in general anesthesia, the lungs were separated by left selective intubation, and the left lung was deflated during the surgical procedure. The surgical complications appeared mainly in the VATS group: one pericardial and one @entity296 leading to sternotomy (minimal @entity190 , uneventful recovery), contralateral @entity456 with pneumothorax. The classical approach accounted for one hemothorax. The postoperative mortality was zero in the VATS group vs. 6 out of 52 pts in the sternotomy group. The postoperative evolution confronted the anesthesiologist with the classical crises of @entity1737 . @entity204 occurred within the first three weeks following surgery. The demise in 3 cases was due to @entity299 (preexisting @entity296 complicated by @entity943 ) and @entity1576 plus @entity295 (for the remaining cases that we lost). The treatment options in the ICU are discussed: plasmapheresis, immunosuppression, ventilatory support. VATS is appropriate for almost all thymectomy, but the outcome is heavily based on a team approach: neurologist, surgeon and anesthetist.

Looking for the best management of XXXX at the Tg.Mure   Clinic of Anesthesia and Intensive Care.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity296 :: ('MESH:D009202', 'Disease') :: ['cardiomyopathy', 'myocardial lesion'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity943 :: ('MESH:D001145', 'Disease') :: ['ventricular arrhythmia'] @entity190 :: ('MESH:D006473', 'Disease') :: ['blood loss'] @entity1737 :: ('MESH:D009157', 'Disease') :: ['myasthenia', 'myasthenia gravis'] @entity1576 :: ('MESH:D012131', 'Disease') :: ['respiratory failure'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac complications'] @entity204 :: ('MESH:D003643', 'Disease') :: ['Death'] @entity456 :: ('MESH:D010995', 'Disease') :: ['pleural lesion']
@entity1737 :: (MESH:D009157,Disease) :: ['myasthenia gravis']
