Thymectomy For Non-thymomatous Myasthenia Gravis: Comparison Of Video-assisted Thoracoscopic & Transsternal Thymectomy
reza bagheri, Sr.1, Reza Boostani2, Maryam Salehi3.
1Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Ma, mashhad, Iran, Islamic Republic of, 2Cardio- Thoracic Surgery & Transplant Research Center, Emam Reza hospital, Faculty of medicine, Ma, Mashhad, Iran, Islamic Republic of, 3department of Community Medicine, Faculty of medicine, Mashhad University of Medical Sciences, Mashhad, Iran., mashhad, Iran, Islamic Republic of.
OBJECTIVE: Thymectomy considered being as a standard procedure in treatment of all the steps of myasthenia gravis. VATS thymectomy is one of the minimally invasive procedure that now because of the short duration of hospitalization, reduced postoperative pain & scarring after surgery have been replaced the traditional methods of surgery for patients with myasthenia gravis, but there are still differences & concerns. The aim of this study is to compare outcomes of two different techniques of surgery, VATS vs. TS in the treatment of myasthenia gravis.
METHODS: 42 patients with myasthenia gravis & lacks a thymus tumor were evaluated as pilot & based on MGFA-classification & drug consumption. Then, they randomly underwent two different techniques of surgery: VATS Vs. TS. Patients were evaluated based on preoperative & postoperative variables.
RESULTS: Length of stay in ICU & hospitalization have been reduced in patients who underwent VATS thymectomy technique. Also duration of surgical procedure has been reduced significantly in these patients. These patients have less blood loss during surgery compared with TS group. The MGFA-postoperative status in VATS thymectomy revealed that the number of persons with complete stable remission was higher & number of persons remained unchanged was lower.
CONCLUSIONS: VATS thymectomy is a safe & appropriate approach versus traditional methods such as TS thymectomy for patients with myasthenia gravis. This method has better results after surgery & can be used as a minimally invasive alternative method instead of TS thymectomy.
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