Efficacy and safety of video-assisted thoracic surgery and median sternotomy in the treatment of thymoma-associated myasthenia gravis

Objective: Our study aims to explore the efficacy and safety of video-assisted thoracic surgery (VATS) and median sternotomy in the treatment of thymoma-associated myasthenia gravis (MG). Methods: The clinical data of 73 patients with thymoma-associated MG from January 2004 to January 2010 in our hospital were analyzed retrospectively. The clinical curative effect, postoperative MG crisis and quality of life of patients with thymomaassociated MG after treated by VATS and median sternotomy were compared. Results: Patients with thymomaassociated MG after treated by VATS and median sternotomy both obtained well curative effects. The intraoperative bleeding volume, postoperative thoracic drainage time, postoperative hospitalization time and intensive care unit (ICU) monitoring time in the VAST group were shorter than that in the median sternotomy group (all P<0.05). The quantitive myasthenia gravis (QMG) score and 15-item myasthenia gravis quality of life scale (MG-QOL15) score of the two groups were significantly improved compared with that before operation (all P<0.05). With the growth of postoperative time, ΔQMG score and ΔMG-QOL15 score were first increased and then decreased in two groups. One year after operation in the VATS group, ΔQMG score and ΔMG-QOL15 score were significantly higher than that in the median sternotomy group (all P<0.05). The occurrence rate of complications especially postoperative MG crisis were significantly higher (P<0.05) while the 5-year mortality rate was slightly higher (P>0.05) in the median sternotomy when compared to that in the VATS group. Conclusion: VATS is more secure than the median sternotomy in patients with thymoma-associated MG; it can also reduce the occurrence of postoperative MG crisis.