Most elderly patients with myasthenia gravis (MG) “safely survive the perioperative period,” according to a new study published in Thoracic Cancer. These patients “benefit from surgery through individualized consideration,” the authors said.
To assess the safety of surgery in patients with MG aged 65 years and over, a team of researchers from China analyzed perioperative data from 564 patients with MG who had surgery at the Department of Thoracic Surgery in Beijing Hospital between November 2011 and March 2022. The researchers divided patients into 2 groups: those below the age of 65 years and those aged 65 years and over.
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The results showed that the lung function (as measured by forced expiratory volume in 1 second, predicted forced expiratory volume in 1 second, and maximal voluntary ventilation) of elderly patients was worse than that of younger patients.
Moreover, their postoperative drainage time was longer and their drainage volume was larger.
The overall health of elderly patients was worse than that of younger patients, and they were more likely to have complications following surgery. They were also more likely to have myasthenic crises following surgery.
The researchers identified the predicted diffusion lung capacity for carbon monoxide as an independent risk factor for complications after the operation, with a lower capacity being associated with a higher risk of complications.
“Surgical indications should be considered in each elderly MG patient on an individual basis,” the researchers concluded. “ After careful evaluation and full preparation before surgery, close observation during and after surgery, and timely response to changes in the condition, the vast majority can safely go through the perioperative period.”
MG is a rare autoimmune disease affecting the neuromuscular junction that is characterized by generalized fatigability and muscle weakness. Surgical removal of the thymus may be indicated in some cases.
Jiao P, Wu F, Wu J, et al. Surgical safety analysis and clinical experience sharing of myasthenia gravis patients aged 65 and over. Thorac Cancer. Published online January 23, 2023. doi:10.1111/1759-7714.14799