Video-assisted Thoracoscopic Extended Thymectomy for Nonthymomatous Myasthenia Gravis / 中国微创外科杂志

ABSTRACT

Objective To investigate curative effects and prognostic factors of video-assisted thoracoscopic extended thymectomy ( VATET ) for nonthymomatous myasthenia gravis ( NTMG ) . Methods Clinical records of 43 patients with an established diagnosis of NTMG who underwent VATET from December 2009 to September 2014 were reviewed. Three-port thoracoscopic right thymectomy with resection of fat tissue in anterior mediastinum was conducted.The curative effects and prognostic factors were evaluated and analyzed with the Monden standard. Results The VATET was successfully completed in all the 43 patients.The operation time was 75-240 min (mean, 115.4 min).The intraoperative blood loss was 10-200 ml (mean, 42.2 ml). No peri-operative death occurred.Follow-ups for 4 -60 months ( mean, 36.2 months) showed 12 cases of remission, 18 cases of improvement, 10 cases of unchanged disease, and 3 cases of deterioration.The effective rate was 69.8% (30/43).Multivariate logistic regression analysis showed that pathological type of thymic hyperplasia was the independent risk factor for NTMG postoperative outcomes (β=0.921,95%CI:1.866-2.811, P=0.000). Conclusion Video-assisted thoracoscopic extended thymectomy is effective in most myasthenia gravis patients.