Clinical Outcome after Thymectomy with or Without Plasmapheresis in Patient with Myasthenia Gravis

Abstract

Objective: To compare clinical outcome in patients with myasthenia gravis who underwent thymectomy with or without Plasmapheresis.Methodology: We studied a total of 47 patients, who were operated on in the period from January 2002 to December 2009 for Myasthenia Gravis .Of these 47 patients, preoperative plasmapheresis was performed in 20 patients (group A) and the remaining 27 patients (group B) had no preoperative plasmapheresis based on non availability of plasmapheresis kit. Outcome in the form of requirement of ventilation, symptomatic improvement, hospital stay andrequirement of drugs were assessed at the end of one year and compared between the two groups.Results: Eighteen out of twenty seven patients (66%) in group B required ventilatory support in the immediate postoperative period, whereas four out of twenty patients (20%) in group A required it. Significant and sustained symptomatic improvement was noted in group A as compared with group B (P-0.01).Conclusion: Preoperative Plasmapheresis in the patients of myasthenia gravis is beneficial and can cause a significant difference in the postoperative outcome.