+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis



Perioperative and long-term outcome of thymectomy for myasthenia gravis: comparison of surgical approaches and prognostic analysis



Chinese Medical Journal 126(1): 34-40



Thymectomy is an established treatment for myasthenia gravis (MG), and video-assisted thoracoscopic surgery (VATS) thymectomy has become an acceptable surgical procedure. This study aimed to compare the results of VATS thymectomy and open thymectomy and to identify the prognostic factors after thymectomy. The clinical data of 187 consecutive thymectomies performed between July 2000 and December 2009 were retrospectively reviewed; 75 open thymectomies and 112 VATS thymectomies. Clinical efficacy and variables influencing outcome were assessed by Kaplan-Meier survival curves and Cox proportional hazards regression analysis. The operative blood loss in the VATS group was significantly less than that in the open group ((62.14 ± 55.43) ml vs. (137.87 ± 165.25) ml, P < 0.05). The postoperative crisis rate increased with the severity of preoperative MG and the prescription dose of anticholinesterase. Complete follow-up information of patients more than 12 months after the thymectomy was obtained on 151 cases, 89 cases from the VATS group and 62 cases from the open group, with a mean follow-up period of 59.3 months, range from 12 to 117 months. Complete stable remission (CSR) was the end point for evaluation of the treatment results. The overall five-year CSR rate was 57.5%. Two good prognostic factors were identified; preoperative prescription of anticholinesterase alone (P = 0.035) and non-thymomatous MG (P = 0.003). The five-year CSR rate of the ocular type of MG reached a high level of 67.4%. Thymectomy can achieve good long-term CSR in MG, and VATS is an ideal alternative method. High-dose prescription of anticholinesterase and the advanced stage by Myasthenia Gravis Foundation of America (MGFA) classification have higher risks of postoperative crisis. Preoperative prescription of anticholinesterase alone and non-thymomatous MG are good prognostic factors. Thymectomy should also be considered for the ocular type of MG.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 054933858

Download citation: RISBibTeXText

PMID: 23286474


Related references

Long-term outcome after thymectomy for myasthenia gravis and analysis of prognostic factors. Fudan Xuebao 33(6): 785-788,793, 2006

Thymectomy for non-thymomatous myasthenia gravis: a comparison of surgical methods and analysis of prognostic factors. EuropeanJournalofCardio-ThoracicSurgery37(1):7, 2010

Searching for prognostic factors at the time of thymectomy for myasthenia gravis. Correlation between outcome after long-term follow-up and immunophenotype of thymic and peripheral blood lymphocytes. Annals of the new York Academy of Sciences 681: 556-560, 1993

Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients. Surgical Endoscopy 22(11): 2470-2477, 2008

The impact of HLA on long-term outcome after thymectomy for myasthenia gravis. Journal of Neuroimmunology 88(1-2): 177-181, 1998

Long-term outcome and factors influencing the outcome of thymectomy for myasthenia gravis. Journal of the Medical Association of Thailand 87(10): 1172-1175, 2004

Long-term clinical outcome after transcervical thymectomy for myasthenia gravis. Annals Of Thoracic Surgery. 65(6): 1520-1522, E, 1998

Long-term outcome and quality of life after thymectomy for myasthenia gravis. Annals of Surgery 224(2): 225-232, 1996

Long-term outcome and relevant factors of thymectomy for myasthenia gravis. Zhonghua Wai Ke Za Zhi 37(3): 159-161, 1999

Long-term outcome of thoracoscopic extended thymectomy for nonthymomatous myasthenia gravis. European Journal of Cardio-Thoracic Surgery 36(1): 164-169, 2009

Long-term prognostic analysis of surgical treatment of the thymoma-associated myasthenia gravis. Khirurgiia 2009(7): 47-54, 2009

Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?1. European Journal of Cardio-Thoracic Surgery 21(4): 664-670, 2002

Thirteen years follow-up after radical transsternal thymectomy for myasthenia gravis. Do short-term results predict long-term outcome?. European Journal of Cardio-Thoracic Surgery 21(4): 664-670, 2002

The long-term outcome of thymectomy combined with steroid therapy for 52 myasthenia gravis patients with thymoma. Chinese Medical Journal (English Edition) 111(3): 223-224, 1998

Perioperative medical management and outcome following thymectomy for myasthenia gravis. Canadian Journal of Anaesthesia 48(5): 446-451, 2001