Long-term results of video-assisted thoracoscopic extended thymectomy for non-thymomatous myasthenia gravis
10.3760/cma.j.issn.1001-4497.2014.08.009
- VernacularTitle:胸腔镜下胸腺扩大切除治疗非胸腺瘤重症肌无力
- Author:
Zhiyi LIU
;
Liang'an LIN
;
Jinlong HUANG
;
Jiansheng YANG
;
Gening JIANG
;
- Publication Type:Journal Article
- Keywords:
Thoracoscopy;
Thymectomy;
Myasthenia gravis
- From:
Chinese Journal of Thoracic and Cardiovascular Surgery
2014;30(8):479-481,487
- CountryChina
- Language:Chinese
-
Abstract:
Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.
