Cardiothoracic Surgery: Cardiothoracic |

The Suitable Dose of Prednisone in the Perioperation of Thoracoscopic Thymectomy FREE TO VIEW

Jinglong Li, MD; Dazhi Pang, MD; Ran Sui, MD; Jianxing He, PhD
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The University of Hong Kong-Shenzhen Hospital, Shenzhen, China

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;149(4_S):A58. doi:10.1016/j.chest.2016.02.061
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SESSION TITLE: Cardiothoracic

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Saturday, April 16, 2016 at 11:45 AM - 12:45 PM

PURPOSE: To study the effect of different doses of prednisone on the recovery of patients with MG from thoracoscopic thymectomy, establishing the safe dose of prednisone in perioperative period.

METHODS: We retrospectively reviewed 32 cases of patients with MG from Mar 2013 to Sept 2014, who underwent thoracocopic thymectomy with administrating prednisone in perioperative period. The cases of patients in control group with daily dose of prednisone less than or equal to 20mg were 17, and the patients in study group with daily dose of prednisone between 21mg and 60mg were 15 cases. The dose and directions for use of prednisone have already been adjusted well by conservative care, so we didn’t change them. According to the modified Osserman type, there were 2 cases of type Ⅰ, 14 cases of type Ⅱb, 1 case of type Ⅲ in control group. There were 1 case of type Ⅰ, 1 case of type Ⅱa, 9 cases of type Ⅱb, 4 cases of type Ⅲ in study group.

RESULTS: No patient converted to open operation, no patient died, without myasthenia crisis occurring, and no incision infected in both group. The blood loss volume of control group and study group were 30.6±21.1ml and 46.7±34.2ml, without significant difference (p=0.115). There was no significant difference between pulmonary complications of control group (23.5%, 4/17) and of study group (25.0%, 3/12) (p=0.810). The ICU stay of control group and study group were 0.4±0.8 days and 0.3±0.8 days, there was no significant difference (p=0.945). The hospital stay of control group and study group were 8.2±4.1 days and 9.8±4.7 days, there was no significant difference (p=0.325). There was also no significant difference of hospital costs between control group and study group (14402.0±2317.2¥, 15449.3±3292.9¥, p=0.302).

CONCLUSIONS: Our data show that perioperative high dose prednisone during thoracoscopic thymectomy do not increase incidence rate of complications such as myasthenia crisis, pulmonary infection or atelectasis, incision infection than routine dose of prednisone. The perioperative daily dose of prednisone equal to or less than 60mg is a safe dosage for the patients with MG. However, a prospective randomized study in a multicenter setting is warranted in order to confirm the efficacy and safety of this approach.

CLINICAL IMPLICATIONS: We can lessen the waiting time due to adjusting dose of prednisone, performe operation as soon as possible, shorten the course of prednisone, reduce the side effect of prednisone and promote the rehabilitation of patients with MG.

DISCLOSURE: The following authors have nothing to disclose: Jinglong Li, Dazhi Pang, Ran Sui, Jianxing He

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