Maastricht UMC+ (MUMC+) is the only Dutch hospital with a multidisciplinary medical and research team that treats patients with thymus disorders, usually using an operating robot. Marcuse is part of this team and has contributed to scientific research at home and abroad for many years. On September 16, she will defend her dissertation Clinical care optimization for patients with a thymic tumor on the thymus and thymus operations.
Thymus
The thymus is located behind the sternum and is important for the development of the immune system. After puberty, the thymus ‘retires’. The organ that was once so prominent (weighing about 40 grams) shrivels until it is barely visible. However, the pile of thymus cells left behind may increase in size. Then there may be overactivity of the thymus, and sometimes even a tumor.
Robotic surgery of the thymus
Since 2004, patients with thymus disorders have been operated on at the MUMC+ using a surgical robot. To improve care, Marcuse first looked at all the outcomes of recent years, in which more than 400 patients were operated on with this technique in the MUMC+. Because the patients were followed up in their own region after the operation, data from the years after the operation were checked in no fewer than 60 Dutch hospitals.
Muscle disease myasthenia gravis
Myasthenia gravis (MG) is a rare muscle disease that can develop at any age and originates in the thymus gland. MG can lead to double vision, swallowing and speaking problems, in severe cases also to the inability to perform daily activities and even to failure of the respiratory muscles. Marcuse concludes in her research that the surgical technique is easily feasible for patients with MG and in most cases even contributes to improving muscle weakness.
Thymoom
Thymomas are a type of tumor that can arise in the thymus, and are more common in patients with MG. Marcuse and her team found that 11% of patients with a thymoma have subclinical (‘dormant’) MG without experiencing symptoms. Nevertheless, 90% of these patients still developed complaints within a number of years, an important outcome for which it is important to inform these patients in good time. In addition, she concluded that radiotherapy, which is performed in 25% of patients with a thymoma after surgery, needs improvement. Marcuse explains: “There is a lack of international guidelines in this area. Small changes in the current way of working can lead to significant consequences for treatment. For example, we found that it is not only the radiotherapist who has to decide which areas need radiation. , but that the surgeon’s vision has a significant influence on the volume to be irradiated. Follow-up research is very important to make the irradiation even more accurate in the future.”
By: National Care Guide
Image: MUMC+