+ 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

Comparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR



Comparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR



European Journal of Cardio-Thoracic Surgery 50(3): 418-422



Thymectomy may be part of the therapeutic strategy in patients with myasthenia gravis (MG) without thymoma. Median sternotomy is still considered as the gold standard, but during the last 15 years, several groups have demonstrated the non-inferiority of cervicotomy with upper sternotomy and minimally invasive techniques. To date, there is no consensus on surgical procedure choice. The aim of our study was to compare the morbidity and mortality of three techniques [cervicotomy with upper sternotomy versus sternotomy versus video-assisted thoracic surgery (VATS)/robotic-assisted thoracic surgery (RATS)] from the national database EPITHOR and to analyse French epidemiology. From the national thoracic surgery database EPITHOR, we have extracted all the details regarding thymectomies performed for non-thymomatous MG. We have divided thymectomy into three groups: A-sternotomy; B-cervicotomy with upper sternotomy; C-VATS/RATS. We investigated the postoperative morbidity and mortality without analysis of the long-term evolution of the disease not available on EPITHOR. From 2005 to 2013, 278 patients were included: 131 (47%) in Group A, 31 (11%) in Group B and 116 (42%) in Group C. The sex ratio F/M was 2.3. The mean age was, respectively, 42 ± 17, 42 ± 16, 35 ± 14 years old (P < 0.01). The number of patients without comorbidities was 63 (48%), 25 (81%) and 78 (65%), respectively (P < 0.01). The operative time was 94 ± 37, 79 ± 42 and 112 ± 59 min, respectively (P < 0.01). The number of patients who presented at least one postoperative complication was 12 (14%), 0 and 3 (9%) (P= 0.03), respectively. The postoperative lengths of stay were 7.7 ± 4.5, 5 ± 1.7 and 4.5 ± 2 days, respectively (P < 0.01). There was no death. In our study, we were unable to prove the superiority of minimally invasive techniques due to the important differences between the groups. However, this study shows us major changes in French surgical procedures during the last decade with an increase in minimally invasive procedures such as VATS and RATS.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 057459111

Download citation: RISBibTeXText

PMID: 26984980

DOI: 10.1093/ejcts/ezw064


Related references

Analysis of outcomes following surgical treatment of thymolipomatous myasthenia gravis: comparison with thymomatous and non-thymomatous myasthenia gravis. Interactive Cardiovascular and Thoracic Surgery 18(4): 475-481, 2014

Studies in myasthenia gravis: effects of thymectomy. Results on 185 patients with nonthymomatous and thymomatous myasthenia gravis, 1941-1969. American Journal of Medicine 50(4): 465-474, 1971

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

Thymectomy for non-thymomatous myasthenia gravis: a propensity score matched study. Orphanet Journal of Rare Diseases 9: 214, 2014

Robotic-assisted thymectomy with Da Vinci II versus sternotomy in the surgical treatment of non-thymomatous myasthenia gravis: early results. Revue Neurologique 169(1): 30-36, 2013

Thymectomy for non-thymomatous myasthenia gravis. Cochrane Database of Systematic Reviews 2013(10): Cd008111, 2013

Is thymectomy in non-thymomatous myasthenia gravis of any benefit?. Interactive Cardiovascular and Thoracic Surgery 18(3): 381-389, 2014

Effectiveness of thymectomy in non-thymomatous myasthenia gravis: a systematic review. Journal of Huazhong University of Science and Technology. Medical Sciences 34(6): 942-949, 2014

Video-assisted thoracoscopic extended thymectomy and extended transsternal thymectomy in non-thymomatous myasthenia gravis patients. Journal of the Neurological Sciences 217(2): 233-4; Author Reply 235-6, 2004

Video-assisted thoracoscopic extended thymectomy and extended transsternal thymectomy (T-3b) in non-thymomatous myasthenia gravis patients: Remission after 6 years of follow-up. Journal of the Neurological Sciences 212(1-2): 31-36, 2003

Comparison of thymectomy with conservative treatment in autoimmune non-thymomatous myasthenia gravis. 2007

Indications, efficacies and periopertive problems of thymectomy in non-thymomatous myasthenia gravis. Rinsho Shinkeigaku 47(11): 872-874, 2007

A crucial first randomized controlled trial of thymectomy in non-thymomatous myasthenia gravis. Journal of Thoracic Disease 8(10): E1375-E1378, 2016

Two-year outcome of thymectomy in non-thymomatous late-onset myasthenia gravis. Journal of Neurology 262(4): 1019-1023, 2015