Surgery MCQ Answer 29
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Answer: A
DISCUSSION:
Although Mestinon therapy results in clinical improvement in most patients, complete remission can be expected in only 10%. In addition, intolerable side effects may limit their usefulness. In patients who fail to respond to Mestinon therapy, and in those who experience significant side effects, corticosteroids can be utilized, with improvement expected in 80% of patients.
Plasma exchange results in improvement in 90% of patients, but the cost of therapy and its transient duration of benefit limit the use of pheresis therapy to special circumstances such as preoperative preparation or in myasthenic crisis.
Overall, response rates to surgical thymectomy range from 80% to 95%, and complete remission occurs in 30% to 50%. This benefit following thymectomy has not been shown to depend on the particular technique utilized.
Remission and response rates are similar for transcervical, standard transsternal, and the “maximal thymectomy” techniques.
Category: Surgery MCQs
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