title: Ten-year results of thoracoscopic unilateral extended thymectomy performed in nonthymomatous myasthenia gravis.
abstract: OBJECTIVE
  The aim of this study was to analyze the 10-year results of thoracoscopic unilateral extended thymectomy (TUET) performed in nontumoral myasthenia gravis according to the Myasthenia Gravis Foundation of America recommendations.
  
  
  BACKGROUND
  Thoracoscopic unilateral extended thymectomy has the benefits of a minimally invasive approach. Previous data have shown promising midterm results but long-term results were lacking.
  
  
  METHODS
  Two hundred forty patients with nontumoral myasthenia gravis who underwent surgery between 1999 and 2009 were eligible for the study. The mean follow-up was of 67 months (range: 12-125), 134 patients completed follow-up assessments more than 60 months after TUET.
  
  
  RESULTS
  There were 39 males (16.3%) and 201 females (83.7%), with an age range from 8 to 60 years. The mean preoperative disease duration was 21.5 months. All patients underwent preoperative steroid therapy. Anticholinesterase drugs were required for 123 patients (51.3%), and immunosuppressive drugs were required for 87 (36.3%) patients. The pathologic findings were as follows: normal thymus in 13 patients (5.5%), involuted thymus in 65 patients (27%), and hyperplastic thymus in 162 patients (67.5%). The average weight of the thymus was 110 ± 45 g. Ectopic thymic tissue was found in 147 patients (61.3%). There was no mortality, and morbidity consisted of 12 patients (5%). Complete stable remission was achieved in 61% of the patients, and the cumulative probability of achieving complete stable remission was 0.88 at 10 years.
  
  
  CONCLUSIONS
  With zero mortality, low morbidity, and comparable long-term results to open surgery, TUET can be regarded as the best treatment option for patients undergoing surgery for myasthenia gravis.
authors: Digestive Diseases and Liver Transplantation Centre, Fundeni Clinical Institute, Bucharest, Romania.
authors: Victor
authors: V
authors: Tomulescu
authors: Olivia
authors: O
authors: Sgarbura
authors: Codrut
authors: C
authors: Stanescu
authors: Crisanda
authors: C
authors: Valciu
authors: Ana
authors: A
authors: Campeanu
authors: Vlad
authors: V
authors: Herlea
authors: Irinel
authors: I
authors: Popescu
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000453:epidemiology / Q000601:surgery*; D016016:Proportional Hazards Models; D013906:Thoracoscopy; D013934:Thymectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D002800:Cholinesterase Inhibitors