Background: There are different surgical techniques used for thymectomy. Each technique
has its own advantages and disadvantages. However, using a less invasive approach would
provide a better outcome.
Methods: From June 2015 to February 2017, a prospective study included a total number of
50 patients of non-thymomatous myasthenia gravis (MG) who were randomly divided into
two groups: group A (25 patients who underwent VATS thymectomy), and group B (25
patients who underwent thymectomy via ministernotomy). Efficacy and outcome of both
procedures were compared. Patients were followed-up for at least one year
postoperatively.
Results: Both procedures were safe and effective in the management of MG. There was no
significant difference between both groups regarding preoperative data. In VATS group,
there were significant decreased operative times (p value ¼ 0.00), significant decreased
blood loss (p value ¼ 0.039), significant decreased postoperative respiratory and cardiac
complications (p value ¼ 0.025 and 0.018 respectively) and significant shorter length of ICU
and hospital stays (p value ¼ 0.039 and 0.007 respectively) when compared to ministernotomy
group. There was no statistically significant difference between both groups
regarding complete stable remissions and clinical improvement. No mortality was recorded
in both groups.
Conclusions: Thoracoscopic thymectomy should be the technique of choice in the management
of MG. It has better intraoperative and short-term results than that of thymectomy
via ministernotomy. However, longer periods of follow-up is needed to evaluate
long-term results properly. |
