Analysis of the therapeutic efficacy of video-assisted thoracoscopic thymectomy in treatment of myasthenia gravis / 中国内镜杂志

ABSTRACT

Objective To assess the effect of video-assisted thoracoscopic thymectomy in treatment of myasthenia gravis (MG) and the factors associated with clinical efficacy. Methods 183 patients with MG who underwent video-assisted thoracoscopic thymectomy from January 2011 to May 2016 were enrolled, and the clinical data were retrospectively analyzed. Therapeutic efficacy was evaluated based on the MGFA. Furthermore, the potential factors associated with the clinical efficacy were analyzed using univariate analysis and Cox's proportional hazards regression model. Results 173 in 183 patients completed the whole follow-up. Among whom, 115 patients achieved complete stable remission (66.5%), 13 patients achieved pharmacologic remission (7.5%), 2 patients achieved minimal manifestations (1.2%), 20 patients had no changes (11.6%), 8 patients showed recurrent MG (4.6%), and 3 patients died (1.7%). Further analysis shown age (RR = 1.53, P = 0.031), pathological type of thymus (RR = 5.84, P = 0.022) and MGFA classification (RR = 3.72, P = 0.028) were main factors associated with the therapeutic efficacy. Conclusions Thoracoscopic expand resection is effective in the treatment of MG patients with satisfactory therapeutic efficacy, and age, pathological type and MGFA type were the main factors associated with the therapeutic efficacy.