title: Sternotomy versus video-assisted thoracoscopic surgery for thymectomy of myasthenia gravis patients: A meta-analysis.
abstract: BACKGROUND
  The purpose of this study was to compare thymectomy by video-assisted thoracoscopic surgery (VATS) and trans-sternal thymectomy (TS) for myasthenia gravis patients.
  
  
  METHODS
  A meta-analysis was conducted to compare thoracoscopic surgery and sternotomy for myasthenia gravis patients with regard to long-term effect and short-term safety.
  
  
  RESULTS
  A total of 23 trials were included in our research. No significant differences were detected with regard to myasthenic crisis, wound infection, and muscle weakness improvement. VATS led to less blood loss than TS (standardized mean difference, -1.233; 95% confidence interval, -1.425--1.041; P < 0.001), less risk of pulmonary infection (relative risk, 1.035; 95% confidence interval, 1.001-1.070; P = 0.043), and a shorter hospital stay. TS had a shorter operative time than VATS (standardized mean difference, 0.239; 95% confidence interval, 0.113-0.365; P < 0.001). VATS and TS achieved similar mean specimen weights and complete stable remission rates.
  
  
  CONCLUSIONS
  Based on the results of this meta-analysis of retrospective cohort studies, VATS increases surgical safety and achieves an equal surgical efficacy to TS, but TS has a shorter operative time.
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Yingtsai
authors.initials: Y
authors.lastname: Gung
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, China.
authors.forename: Hanlu
authors.initials: H
authors.lastname: Zhang
authors.affiliation: West China College of Public Health of Sichuan University, Chengdu, China.
authors.forename: Shizhu
authors.identifier: http://orcid.org/0000-0002-1363-8498
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu, China. yunwwang@yeah.net.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wang
mesh_terms: D006801:Humans; D009157:Myasthenia Gravis / Q000601:surgery*; D056346:Sternotomy; D020775:Thoracic Surgery, Video-Assisted; D013934:Thymectomy; D016896:Treatment Outcome
keywords: Myasthenia gravis; sternotomy; video-assisted thoracoscopic surgery