Tratamento cirúrgico comparado ao tratamento clínico na miastenia gravis: revisão sistemática e matanálise

• Ano de defesa: 2015
• Autor(a) principal: Felisberto Junior, Gilmar [UNESP]
• Tipo de documento: Dissertação
• Tipo de acesso: Acesso aberto
• Idioma: por
• Instituição de defesa: Universidade Estadual Paulista (Unesp)
• Palavras-chave em Português: Miastenia grave; Tratamento cirurgico; Sistema imune; Timo - Cirurgia; Myasthenia gravis; Surgery
• Link de acesso: http://hdl.handle.net/11449/132120; http://www.athena.biblioteca.unesp.br/exlibris/bd/cathedra/02-10-2015/000848649.pdf

Introduction: Myasthenia gravis is a disease that affects the neuromuscular junction and leads to weakness of the skeletal muscles. Current treatment is guided by the clinical and surgical conduction through the complete resection of the thymus. Objective: Compare, through a systematic review, the results of surgical and medical treatment of myasthenia gravis. Methods: A search was conducted in major databases to find randomized controlled trials that compared the two treatment modalities. As there are no studies that category, were selected studies with a lower level of evidence and that contained both interventions and at least 10 patients in each arm of the study. Statistical analysis was performed with StatsDirect version 3.0.121 software. Results: The search found 592 articles in Medline, 1925 articles in the Embase and 204 articles in the Lilacs. After exclusion of duplicate studies, 51 articles were fully analyzed and nine were selected for this review. The total number of patients was 3,211. The mortality in the surgical and medical groups were respectively 7 and 19%, with significant differences. The remission rate in both groups was 17% for the surgical group and 13% for clinical, without statistical significance. To improve the outcome, the surgical group had a rate of 23% and 29% of the clinical, also no statistical difference. Conclusion: Despite the low available evidence, thymectomy may be considered a therapeutic option in myasthenia gravis, with lower rates of mortality and rates of remission and control similar to clinical treatment Keywords: myasthenia gravis, thymectomy, clinical treatment