[Mid-, and long-term effects of video-assisted thoracoscopic and transsternal thymectomy in treatment of non-thymomatous myasthenia gravis: analysis of 204 cases].
OBJECTIVE
To evaluate the mid-, and long-term effects of video-assisted thoracoscopic thymectomy and transsternal thymectomy in treatment of myasthenia gravis (MG) and to identify the prognostic factors for thymectomy success.


METHODS
161 patients with non-thymomatous MS, 84 males and 120 females, aged 33, underwent transsternal thymectomy and were followed up for 5 years; and 43 patients with non-thymomatous MS A retrospective, 1 male and 25 females, 21 being aged >40 during operation, underwent thoracoscopic thymectomy and were followed up for 3 years.


RESULTS
The mean operating time of the thoracoscopic group was (132 +/- 32) min minutes, significantly longer than that of the transsternal thymectomy group [(96 +/- 18) min, P = 0.000]. Four patients in the transsternal thymectomy group and 41 in the transsternal thymectomy group developed myasthenic crises (P = 0.023). The complete stable remission (CSR) rates 1, 2, and 3 years after operation of the thoracoscopic thymectomy group were 34.9%, 41.9%, and 46.5% respectively; and CSR rates 1, 2, 3, and 5 years after operation of the transsternal thymectomy group were 26.7%, 31.7%, 35.4%, and 40.4% respectively, without significant differences between these 2 groups.


CONCLUSIONS
Both thoracoscopic and transsternal approaches to thymectomy in patients with MG are effective in terms of remission. The authors advocate adopting the thoracoscopic approach early.
Yu
Lei
L
Department of Thoracic Surgery, Beijing Tongren Hospital, Capital University of Medical Sciences, Beijing 100730, China.
Wanf
Tian-you
TY
Ma
Shan
S
Jing
Yun
Y
Li
Jian-ye
JY
Jiang
Jian
J
Zhang
Yun-feng
YF
Zang
Nan
N
Huo
Cheng-yu
CY
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000601:surgery*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013906:Thoracoscopy; D013908:Thoracotomy; D013934:Thymectomy / Q000379:methods*; D013997:Time Factors