Table of Contents
ISRN Neurology
Volume 2013, Article ID 238783, 6 pages
http://dx.doi.org/10.1155/2013/238783
Clinical Study

Preoperative Plasmapheresis for Elective Thymectomy in Myasthenia Patient: Is It Necessary?

1General Thoracic Unit, Department of Surgery, Faculty of Medicine, Chiang Mai University Hospital, Chaing Mai 50200, Thailand
2Department of Pathology, Faculty of Medicine, Chiang Mai University Hospital, Chaing Mai 50200, Thailand
3Department of Radiology, Faculty of Medicine, Chiang Mai University Hospital, Chaing Mai 50200, Thailand

Received 13 May 2013; Accepted 30 May 2013

Academic Editors: C.-M. Chen, C.-Y. Hsu, D. Mathieu, A. K. Petridis, and D. Schiffer

Copyright © 2013 Somcharoen Saeteng et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Role of plasmapheresis before thymectomy remains controversial. The aim of this study is to determine the peri-operative and post-operative outcome of a thymectomy between performing and not performing a pre-operative plasmaphreresis. Patients and Methods. A retrospective chart review study was conducted in Chiang Mai University Hospital between January 2006 and December 2011. There were 86 myasthenia patients divided into two groups; Preoperative plasmapheresis group (PPG) and no preoperative plasmapheresis group (NPPG). The primary outcome involved post-operative extubation and the secondary outcome included post-operative complications, 28 day mortality and length of hospital stay. Results. Eighty-six patients were enrolled in this study. The number of patients who had a history of myasthenic crisis at any time or within one month in the PPG was significantly more than those in the NPPG. Muscle power and forced expiratory vital capacity in the NPPG was higher than that in the PPG. The postoperative extubation rate was similar in both groups. After controlling for the propensity score, there were no statistically significant differences in both of primary and secondary outcomes. Conclusion. The results of this study shows no significant differences between both groups in all outcomes, therefore the pre-operative plasmaphresis is not necessary for elective thymectomy.