Abstract: Objective To compare the efficacy of surgery (video-assisted thoracoscopic, VATS) and median sternotomy in the treatment of myasth
Abstract: Objective To compare the efficacy of surgery (video-assisted thoracoscopic, VATS) and median sternotomy in the treatment of myasthenia gravis. Methods a retrospective analysis of our department from July 1998 to May 2007 for enlarged thymus resection in 195 cases of clinical data of patients with myasthenia gravis treated, according to different surgical methods, they were divided into VATS group (83 cases) and median incision thoracotomy group (112 cases), using independent samples t test analysis of operation time, intraoperative blood loss, postoperative drainage, storm duration (gravis mechanical ventilation time) and other indicators, 2 test was used in analysis of postoperative myasthenic crisis rate. Results VATS group of patients after surgery with drainage incision thoracotomy group increased (164.65 + 38 vs. 98.26 + 26.84, P=0.023), the intraoperative blood loss compared with the median thoracotomy group decreased (53.24 + 11.69 vs. 97.37 + 24.61, P=0.036); VATS group of postoperative myasthenic crisis occurred in 4.82% (4/83). The median thoracotomy group postoperative myasthenic crisis occurred in 13.4% (15/112), there were statistically significant differences between the two groups (P=0.046; OR=3.054). The mechanical ventilation time in VATS group after operation required a thoracotomy group was significantly shorter (75.33 + 39.31 vs. 189.20 + 89.74, P=0.012). Conclusion thoracoscopic extended thymectomy for myasthenia gravis has good safety, less bleeding, small trauma, can reduce the occurrence of myasthenia crisis after operation, shorten the mechanical ventilation time required for myasthenia crisis after operation, and has a good application prospect.
Key words: video assisted thoracoscopic surgery; extended resection of thymus; myasthenia gravis; early treatment