Original articleGeneral thoracicComparative Clinical Outcomes of Thymectomy for Myasthenia Gravis Performed by Extended Transsternal and Minimally Invasive Approaches
Section snippets
Material and Methods
The study was carried out at University of Texas Southwestern Medical Center at Dallas and Medical City Dallas Hospital with a retrospective chart review of all cases done from March 1992 to June 2006. Preoperative clinical staging was assessed by the MGFA clinical classification [8]. Medication usage and existing comorbidities were also recorded. Patient follow-up was by clinical appointment visits as well as by scripted telephone contact and included information as to patient status as
Results
Ninety-five patients with myasthenia gravis were included in the study, consisting of 48 VATS patients and 47 transsternal patients. Clinical follow-up was 89.5% complete, with a mean follow-up of 6.0 ± 4.0 years (median = 6.1 years) in the VATS group and 4.3 ± 2.9 years (median = 4.2 years) in the transsternal patient group (p = 0.03).
The mean age in the transsternal group was 34.4 ± 13.2 years, versus 39.8 ± 14.9 years in the VATS group. There were no significant differences in patient
Comment
The earliest reported thymectomy in a myasthenia gravis patient was by Schumacher and Roth in 1912 [10]. However, it was the report by Blalock and colleagues [1] in 1941 that led to the widespread adoption of thymectomy in the management of myasthenia gravis. Since that time, both medical and surgical approaches have been advocated in the absence of rigorous randomized trials on which to draw firm conclusions regarding proper management in nonthymomatous myasthenia gravis. Similarly, different
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