Mediastinal tumor resection in a patient with spinocerebellar degeneration.
Analgesics, Opioid
/ therapeutic use
Anesthesia, General
/ methods
Anesthetics, Intravenous
/ therapeutic use
Female
Humans
Middle Aged
Neuromuscular Nondepolarizing Agents
/ therapeutic use
One-Lung Ventilation
Propofol
/ therapeutic use
Remifentanil
/ therapeutic use
Rocuronium
/ therapeutic use
Spinocerebellar Degenerations
/ complications
Thoracic Surgery, Video-Assisted
/ methods
Thymectomy
/ methods
Thymoma
/ complications
Thymus Neoplasms
/ complications
Mediastinal tumor
Spinocerebellar degeneration
Surgery
Journal
Journal of cardiothoracic surgery
ISSN: 1749-8090
Titre abrégé: J Cardiothorac Surg
Pays: England
ID NLM: 101265113
Informations de publication
Date de publication:
29 Jul 2020
29 Jul 2020
Historique:
received:
03
03
2020
accepted:
08
07
2020
entrez:
31
7
2020
pubmed:
31
7
2020
medline:
6
1
2021
Statut:
epublish
Résumé
In spinocerebellar degeneration (SCD) patients, general and regional anesthesia may cause postoperative dysfunction of respiratory, nerve and muscle systems. We present the surgical case of thymoma developed in patient with SCD. A 47-year-old woman with spinocerebellar degeneration was admitted because of a well-defined mass measuring 48 × 31 mm in anterior mediastinum. She showed limb, truncal, ocular, and speech ataxia; hypotonia; areflexia; sensory disturbances; and muscle weakness. Her eastern cooperative oncology group performance status was 4. Surgical resection was performed via video-assisted thoracic surgery and under general anesthesia only without epidural analgesia. The mass was diagnosed as type B1 thymoma without capsular invasion (Masaoka stage I). The patients got a good postoperative course by cooperation with anesthesiologists and neurologists in perioperative managements. She has been well over 3 years of follow-up. In conclusion, careful surgical and anesthesia management is essential for providing an uneventful postoperative course in patients with SCD. Especially, selection of minimal invasive approach and avoid diaphragmatic nerve damage are the most important points in surgical procedures.
Sections du résumé
BACKGROUND
BACKGROUND
In spinocerebellar degeneration (SCD) patients, general and regional anesthesia may cause postoperative dysfunction of respiratory, nerve and muscle systems. We present the surgical case of thymoma developed in patient with SCD.
CASE PRESENTATION
METHODS
A 47-year-old woman with spinocerebellar degeneration was admitted because of a well-defined mass measuring 48 × 31 mm in anterior mediastinum. She showed limb, truncal, ocular, and speech ataxia; hypotonia; areflexia; sensory disturbances; and muscle weakness. Her eastern cooperative oncology group performance status was 4. Surgical resection was performed via video-assisted thoracic surgery and under general anesthesia only without epidural analgesia. The mass was diagnosed as type B1 thymoma without capsular invasion (Masaoka stage I). The patients got a good postoperative course by cooperation with anesthesiologists and neurologists in perioperative managements. She has been well over 3 years of follow-up.
CONCLUSIONS
CONCLUSIONS
In conclusion, careful surgical and anesthesia management is essential for providing an uneventful postoperative course in patients with SCD. Especially, selection of minimal invasive approach and avoid diaphragmatic nerve damage are the most important points in surgical procedures.
Identifiants
pubmed: 32727532
doi: 10.1186/s13019-020-01218-8
pii: 10.1186/s13019-020-01218-8
pmc: PMC7389681
doi:
Substances chimiques
Analgesics, Opioid
0
Anesthetics, Intravenous
0
Neuromuscular Nondepolarizing Agents
0
Remifentanil
P10582JYYK
Rocuronium
WRE554RFEZ
Propofol
YI7VU623SF
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
197Références
Muscle Nerve. 1999 Jun;22(6):712-7
pubmed: 10366224
J Neurol. 2000 Oct;247(10):812-3
pubmed: 11127543
J Anaesthesiol Clin Pharmacol. 2011 Apr;27(2):249-52
pubmed: 21772692
Anesth Analg. 1997 Nov;85(5):1071-3
pubmed: 9356102
Can J Anaesth. 2007 Jun;54(6):467-70
pubmed: 17541076
Brain. 1997 Dec;120 ( Pt 12):2141-8
pubmed: 9448569
Anaesthesia. 1982 Jun;37(6):695-6
pubmed: 6211998
Ann Thorac Cardiovasc Surg. 2000 Apr;6(2):125-6
pubmed: 10870008