Comparison of Clinical Outcomes of Thymectomy for Myasthenia Gravis: ThoracoscopicThymectomyvsTranssternalThymectomy

Abstract

Objective:Thoracoscopicthymectomy has become increasingly popular as a surgical treatment for myasthenia gravis because of its better cosmetic results and comparable efficacy compared with conventional open surgery. We review our outcomes of both techniques.
Methods: Between January 2004 and January 2008, 57 thymectomies were performed for myasthenia gravis; 27 by thoracoscopicthymectomyand 30 by transsternalthymectomy. Preoperative classification and Post-operative disease status were compared between the groups.
Results: Mean age was 36.6 (thoracoscopicthymectomy) versus 40.0 years (transsternalthymectomy) (p =0.342); the preoperative duration of myasthenia gravis was 15.9 versus 17.4 months (p =0.76) and mean of clinical follow up was 6.5vs 7.5 years (p =0.0003) respectively. In thoracoscopicthymectomy group, no patient required conversion to sternotomy technique. The median operative time was 165 min (range, 45-255) in thoracoscopicgroup vs. 135 min (range, 80-190) in transsternal group (p<0.05). Mean length of stay was 3.8 versus 5.2 days (p< 0.05) respectively. Post-operative DeFilippi classification for remission revealed improvement in 88% of thoracoscopic group versus 87 % in transsternal group. (p = 0.81)
Conclusion: Thoracoscopicthymectomy is an effective treatment for myasthenia gravis which decreases hospital stay with equivalent clinical outcomes when compared with transsternalthymectomy.

Keywords: Video-assisted thymectomy,thymectomy,myasthenia gravis,thoracoscopicthymectomy