grekovВестник хирургии имени И.И. ГрековаGrekov's Bulletin of Surgery0042-46252686-7370Federal State Budgetary Educational Institution of Higher Education «Academician I.P. Pavlov First St. Petersburg State Medical University» of the Ministry of Healthcare of the Russion Federation, FSBEI HE I.P.Pavlov SPbSMU MOH Russia10.24884/0042-4625-2024-183-5-49-56grekov-2322Research ArticleОБЗОРЫREVIEWSРоль тимэктомии в лечении миастенииThe role of thymectomy in the treatment of myastheniahttps://orcid.org/0000-0001-5221-8536МартыноваД. Е.MartinovaD. Ye.

Мартынова Дина Евгеньевна, врач-торакальный хирург торакального отделения

125284, Москва, 2-й Боткинский проезд, д. 3

Martinova Dina Ye., Thoracic Surgeon of the Thoracic Department

Moscow

martinovadina92@yandex.ruhttps://orcid.org/0000-0001-6871-6804ПикинО. В.PikinО. V.

Пикин Олег Валентинович, доктор медицинских наук, профессор, руководитель отделения торакальной хирургии

125284, Москва, 2-й Боткинский проезд, д. 3

Pikin Oleg V., Dr. of Sci. (Med.), Professor, Head of the Department of Thoracic Surgery

Moscow

pikin_ov@mail.ruhttps://orcid.org/0000-0002-1037-2364РябовА. Б.RyabovA. B.

Рябов Андрей Борисович, доктор медицинских наук, профессор, зам. генерального директора НМИЦ радиологии по хирургии, руководитель отдела торакоабдоминальной онкохирургии 

125284, Москва, 2-й Боткинский проезд, д. 3

Ryabov Andrey B., Dr. of Sci. (Med.), Professor, Deputy General Director of National Medical Research Radiological Centre for Surgery, Head of the Department of Thoracoabdominal Oncosurgery

Moscow

ryabovdoc@mail.ruhttps://orcid.org/0000-0002-3013-9658ЩербаковаН. И.SherbakovaN. I.

Щербакова Наталья Ивановна, доктор медицинских наук, профессор, врач-невролог

125284, Москва, 2-й Боткинский проезд, д. 3

Sherbakova Natalya I., Dr. of Sci. (Med.), Professor, Neurologist

Moscow

shnata@inbox.ruМосковский научно-исследовательский онкологический институт имени П. А. Герцена – филиал Национального медицинского исследовательского центра радиологииРоссияР. A. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreRussian Federation20242207202418354956Copyright © Мартынова Д.Е., Пикин О.В., Рябов А.Б., Щербакова Н.И., 20242024Мартынова Д.Е., Пикин О.В., Рябов А.Б., Щербакова Н.И.Martinova D.Y., Pikin О.V., Ryabov A.B., Sherbakova N.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.vestnik-grekova.ru/jour/article/view/2322

Проведен систематический обзор данных отечественной и зарубежной литературы, посвященных лечению миастении. Особое внимание уделено показаниям к тимэктомии и ее эффекту в зависимости от различных факторов прогноза. С целью поиска источников использованы базы данных Pubmed, eLibrary, UpToDate. На основе анализа литературных источников представлены данные лечении миастении при опухолевой и неопухолевой патологии вилочковой железы, уточнены показания к хирургическому лечению. Проведен краткий исторический обзор использования хирургического метода у больных с миастенией. Описаны методы консервативного лечения. Уделено внимание современным тенденциям в выборе хирургического доступа при миастении, а также повторным операциям при рефрактерном течении миастении.Малоинвазивная тимэктомия является патогенетически обоснованным, современным, безопасным и воспроизводимым вариантом лечения больных с тимомной и нетимомной миастенией.

A systematic review of the data of domestic and foreign literature on the treatment of myasthenia was carried out. Special attention was paid to indications for thymectomy and its effect depending on various prognostic factors. Pubmed, Elibrary, UpToDate databases were used to search for sources. Based on the analysis of literary sources, data on the treatment of myasthenia in tumor and non-tumor pathology of the thymus gland was presented; indications for surgical treatment were clarified. A brief historical review of the use of the surgical method in patients with myasthenia was carried out. The methods of conservative treatment were described. Attention was paid to current trends in surgical approaches for myasthenia as well as repeated operations for refractory course of myasthenia.Minimally invasive thymectomy is a pathogenetically justified, modern, safe and reproducible treatment option for patients with thymic and non-thymic myasthenia.

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The authors declare that there are no conflicts of interest present.