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Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
Tomsk State University

Gusakov V.V.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

Comparison of prognostic scales of myasthenic crisis after thymectomy in patients with myasthenia gravis

Authors:

Topolnitskiy E.B., Gusakov V.V.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2024;(6): 63‑69

DOI: 10.17116/anaesthesiology202406163

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Table of contents

COMPARISON OF PROGNOSTIC SCALES OF MYASTHENIC CRISIS AFTER THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS
COMPARISON OF PROGNOSTIC SCALES OF MYASTHENIC CRISIS AFTER THYMECTOMY IN PATIENTS WITH MYASTHENIA GRAVIS

To cite this article:

Topolnitskiy EB, Gusakov VV. Comparison of prognostic scales of myasthenic crisis after thymectomy in patients with myasthenia gravis. Russian Journal of Anesthesiology and Reanimatology. 2024;(6):63‑69. (In Russ.)
https://doi.org/10.17116/anaesthesiology202406163

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Myasthenia gravis (MG) is an autoimmune disease accompanied by muscle weakness and abnormal muscle fatigue. Thymectomy (TE) is advisable for these patients. Some anesthetic prognostic scales were proposed to assess the likelihood of postoperative myasthenic crisis (POMC). There are no literature data on comparison of prognostic scales for this postoperative complication.

OBJECTIVE

To compare prognostic effectiveness of different scales in prediction of POMC after TE in MG patients.

MATERIAL AND METHODS

We retrospectively analyzed 37 case histories of seropositive MG patients who underwent TE under general anesthesia. ROC-analysis was performed to compare 5 prognostic sales.

RESULTS

The scale by T. Kanai et al. with VC% (0.93 [95% CI 47.8—100.0]) and FVC% (0.90 [95% CI 47.8—100]), as well as QMGS scale (0.94 [95% CI 89.1—100.0]) showed higher results compared to scales by S.R. Leventhal et al. (0.67 [95% CI 14.7—94.7]) and G. Leuzzi et al. (0.80 [95% CI 58.4—99.5]) in predicting POMC. Pairwise comparison with DeLong test found no significant differences.

CONCLUSION

Kanai and QMGS scales are preferable for prediction of postoperative myasthenic crisis after thymectomy in patients with myasthenia gravis.

Keywords:

myasthenia
myasthenic crisis
anesthesia
thoracoscopic thymectomy
prognostic scales
perioperative management

Authors:

Topolnitskiy E.B.

Siberian State Medical University;
Tomsk Regional Clinical Hospital;
Tomsk State University

Gusakov V.V.

Siberian State Medical University;
Tomsk Regional Clinical Hospital

Received:

16.06.2024

Accepted:

17.07.2024

List of references:

  1. Salahoru P, Grigorescu C, Hinganu MV, Lunguleac T, Halip AI, Hinganu D. Thymus Surgery Prospectives and Perspectives in Myasthenia Gravis. Journal of Personolized Medicine. 2024;14(3):241.  https://doi.org/10.3390/jpm14030241
  2. Topolnitskiy EB, Borodina YuA. Videothoracoscopic interventions for tumors and cysts of the mediastinum. Endoscopic Surgery. 2020;26(6):17-21. (In Russ.). https://doi.org/10.17116/endoskop20202606117
  3. Podobed AV. Long-term outcomes of thoracoscopic thymectomy for thymoma stage I—II. Pirogov Russian Journal of Surgery. 2021;(8):58-62. (In Russ.). https://doi.org/10.17116/hirurgia202108158
  4. Kurganov IA, Panchenkov DN, Bogdanov DIu, Emelyanov SI, Ivanov YuV, Khabarov YuA, Urazovskiy NYu. Comparative analysis of thymectomies through videothoracoscopic and transsternal approaches. Endoskopicheskaya khirurgiya. 2018;24(2):21-29. (In Russ.). https://doi.org/10.17116/endoskop201824221
  5. Pikin OV, Ryabov AB, Martinova DYe, Salimov ZM. Minimally invasive techniques in thymic surgery (review of literature). Vestnik khirurgii im. I.I. Grekova. 2021;180(4):99-105. (In Russ.). https://doi.org/10.24884/0042-4625-2021-180-4-99-105
  6. Zhikharev VA, Porkhanov VA, Koryachkin VA, Malyshev YuP, Danilov VV. Video-assisted thoracoscopic thymectomy in myasthenia. A new approach. Messenger of Anesthesiology and Resuscitation. 2018;15(3):14-19. (In Russ.). https://doi.org/10.21292/2078-5658-2018-15-3-14-19
  7. Kavochkin AA, Vyzhigina MA, Kabakov DG, Bazarov DV, Zaytsev AYu, Zhukova SG, Grigorchuk AYu, Shinkarenko YaV. Anesthesiological management of thoracoscopic operations on lungs and mediastinum. Messenger of Anesthesiology and Resuscitation. 2020;17(4):113-122. (In Russ.). https://doi.org/10.21292/2078-5658-2020-17-4-113-122
  8. Chubchenko NV, Vasilieva GN, Domanskaya IA, Lebedinskii KM. Acceleromyographic assessment of sevoflurane-induced neuromuscular block. Russian Journal of Anesthesiology and Reanimatology. 2020;(6):62-68. (In Russ.). https://doi.org/10.17116/anaesthesiology202006162
  9. Chubchenko NV, Lebedinskii KM. Monitoring of various types of neuromuscular blockade. Messenger of Anesthesiology and Resuscitation. 2016; 13(6):64-71. (In Russ.).
  10. Zabolotskikh IB, Belkin AA, Butrov AV, Kondratiev AN, Lebedinskii KM, Lubnin AYu, Magomedov MA, Nikolaenko EM, Ovechkin AM, Shifman EM, Schegolev AV. Perioperative management of patients with neuromuscular diseases. Russian Journal of Anesthesiology and Reanimatology. 2019;(1):6-26. (In Russ.). https://doi.org/10.17116/anaesthesiology20190116
  11. Zabolotskikh IB, Belkin AA, Butrov AV, Gorbachev VI, Golubtsov VV, Ershov VI, Kondratiev AN, Kuzovlev AN, Lebedinskii KM, Lubnin AYu, Magomedov MA, Ovechkin AM, Savvina IA, Shadrin RV, Shifman EM, Shchegolev AV. Perioperative management of patients with neuromuscular diseases. Guidelines. Russian Journal of Anesthesiology and Reanimatology. 2022;(6):6-28. (In Russ.). https://doi.org/10.17116/anaesthesiology20220616
  12. Shefer NA, Topolnitskiy EB. Enhanced recovery after lung resection in high-risk patients. Pirogov Russian Journal of Surgery. 2023;(2):21-29. (In Russ.). https://doi.org/10.17116/hirurgia202302121
  13. Mishra AK, Varma A. Myasthenia Gravis: A Systematic Review. Cureus. 2023;15(12):e50017. https://doi.org/10.7759/cureus.50017
  14. Kotov SV, Sidorova OP. Outcomes and treatment of myasthenic crisis. S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(11):103-105. (In Russ.). https://doi.org/10.17116/jnevro2016116111103-105
  15. Rushkevich YuN, Haliyeuskaya OV, Kulikova YuS, Chechyk NM, Likhachev SA. Non-invasive ventilation of the lungs in neuromuscular diseases. S.S. Korsakov Journal of Neurology and Psychiatry. 2021;121(8):77-82. (In Russ.). https://doi.org/10.17116/jnevro202112108177
  16. Claytor B, Cho S-M, Li Y. Myasthenic crisis. Muscle and Nerve. 2023;68(1): 8-19:e50017. https://doi.org/10.1002/mus.27832
  17. Kanai T, Uzawa A, Sato Y, Suzuki S, Kawaguchi N, Himuro K, Oda F, Ozawa Y, Nakahara J, Suzuki N, Takahashi YK, Ishibashi S, Yokota T, Ogawa T, Yokoyama K, Hattori N, Izaki S, Oji S, Nomura K, Kaneko J, Nishiyama K, Yoshino I, Kuwabara S. A clinical predictive score for postoperative myasthenic crisis. Annals of Neurology. 2017;82(5):841-849.  https://doi.org/10.1002/ana.25087
  18. Leventhal SR, Orkin FK, Hirsh RA. Prediction of the need for postoperative mechanical ventilation in myasthenia gravis. Anesthesiology. 1980; 53(1):26-30.  https://doi.org/10.1097/00000542-198007000-00006
  19. Leuzzi G, Meacci E, Cusumano G, Cesario A, Chiappetta M, Dall’armi V, Evoli A, Costa R, Lococo F, Primieri P, Margaritora S, Granone P. Thymectomy in myasthenia gravis: proposal for a predictive score of postoperative myasthenic crisis. European Journal of Cardio-Thoracic Surgery. 2014;45(4):e76-88.  https://doi.org/10.1093/ejcts/ezt641
  20. Besinger UA, Toyka KV, Hömberg M, Heininger K, Hohlfeld R, Fateh-Moghadam A. Myasthenia gravis: long-term correlation of binding and bungarotoxin blocking antibodies against acetylcholine receptors with changes in disease severity. Neurology. 1983;33(10):1316-1321. https://doi.org/10.1212/wnl.33.10.1316
  21. Liu C, Liu P, Zhang XJ, Li WQ, Qi G. Assessment of the risks of a myasthenic crisis after thymectomy in patients with myasthenia gravis: a systematic review and meta-analysis of 25 studies. Journal of Cardiothoracic Surgery. 2020;15(1):270.  https://doi.org/10.1186/s13019-020-01320-x
  22. Sanadze AG. Miasteniya i miastenicheskie sindromy. Rukovodstvo dlya vrachej. M.: LitTerra; 2012. (In Russ.).
  23. Alqarni F, Almalki D, Aljohani Z, Ali A, AlSaleem A, Alotaibi N, Odeh S, Al Dalbhi S. Prevalence and risk factors of myasthenia gravis recurrence post-thymectomy. Neurosciences (Riyadh, Saudi Arabia). 2021;26(1):4-14.  https://doi.org/10.17712/nsj.2021.1.20190041
  24. Aleksandrov OA, Pikin OV, Ryabov AB, Stepanov SO, Volchenko NN. Clinical presentations and morphological verification of mediastinal tumors. P.A. Herzen Journal of Oncology. 2020;9(5):60-70. (In Russ.). https://doi.org/10.17116/onkolog2020905160
  25. Kurganov IA, Emelyanov SI. Currant approaches to the choice of the method of endoscopic thymectomy. Endoscopic Surgery. 2023;29(3):62-72. (In Russ.). https://doi.org/10.17116/endoskop20232903162
  26. Jiao P, Wu F, Liu Y, Wu J, Sun Y, Tian W, Yu H, Huang C, Li D, Wu Q, Ma C, Tong H. Analysis of influencing factors of perioperative myasthenic crisis in 387 myasthenia gravis patients without thymoma in a single center. Journal of Cardiothoracic Surgery. 2023;18(1):20.  https://doi.org/10.1186/s13019-023-02136-1
  27. Jiao P, Wu F, Liu Y, Wu J, Sun Y, Tian W, Yu H, Huang C, Li D, Wu Q, Ma C, Tong H. Analysis of influencing factors of postoperative myasthenic crisis in 564 patients with myasthenia gravis in a single center. Thoracic Cancer. 2023;14(5):517-23.  https://doi.org/10.1111/1759-7714.14774

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