000			03183cam a2200349 a 4500
003			EG-GiCUC
005			20250223032753.0
008			210626s2021 ua dh f m 000 0 eng d
040			_aEG-GiCUC _beng _cEG-GiCUC
041	0		_aeng
049			_aDeposite
097			_aPh.D
099			_aCai01.11.05.Ph.D.2021.Al.F
100	0		_aAli Elsayed Abdelgayed Hetiba
245	1	0	_aFactors predicting surgical outcome of thymectomy in myasthenia gravis / _cAli Elsayed Abdelgayed Hetiba ; Supervised Ehab Mohamed Elshihy , Tarek Ahmed Abbas Mohsen , Alaa Mohammed Omar
246	1	5	_aالعوامل المؤثره علي نتائج استئصال الغده التيموسيه فى مرضى وهن العضلات
260			_aCairo : _bAli Elsayed Abdelgayed Hetiba , _c2021
300			_a79 P. : _bcharts , facimiles ; _c25cm
502			_aThesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Cardiothoracic Surgery
520			_aBackground: Myasthenia gravis (MG) is a disease affecting the neuromuscular junction and manifests as muscular weakness and fatigability. Thymectomy may benefit patients with MG.This operation can be performed through several different approaches. Many studies tried to analyze all factors could affect the outcome after thymectomy to identify which group of patients will benefit from surgery.Patient and methods: one hundred patients underwent thymectomy for myasthenia gravis in the period between June 2019 and November 2020 in Kasr Alainy hospitals were recruited to this study to evaluate predictors of outcome after thymectomy in the management of non thymomatous myasthenia gravis. Preoperative assessment included age, gender, co morbidities, MGFA classification, medication, plasmaphresis, also all patients performed CT chest, EMG and AChR Ab titre. Thymectomy was performed either by transsternal or VATS approach with documentation of the extent of resection; primary outcome was assessment of improvement by MGFA classification and need for medication.Secondary outcome was postoperative complications. Results: Complete stable remission was achieved in 5 patients, clinical and pharmacological improvements were achieved in 71 patients, 21 patients didn{u2019}t improve and only 3 patients worsen after surgery.Improvement rates in early onset of MG, patients didn{u2019}t have preoperative comorbidities and patients to whom extended thymectomy was performed were 79.3%, 77.3 % and 87.3% respectively. Also patients in whom postoperative AChR Ab decreased obviously had significant higher improvement rate. Although severely symptomatic patients had worse outcome, the correlation between preoperative MGFA classification and postoperative outcome was statistically insignificant (p value = 0.07)
530			_aIssued also as CD
653		4	_aMyasthenia gravis
653		4	_aOutcome
653		4	_aThymecomy
700	0		_aAlaa Mohammed Omar , _eSupervisor
700	0		_aEhab Mohamed Elshihy , _eSupervisor
700	0		_aTarek Ahmed Abbas Mohsen , _eSupervisor
856			_uhttp://172.23.153.220/th.pdf
905			_aNazla _eRevisor
905			_aShimaa _eCataloger
942			_2ddc _cTH
999			_c81397 _d81397