ArticleJournal of thoracic disease2020
Perioperative outcomes and mid-term effects in performing video-assisted thoracoscopic extended thymectomy for myasthenia gravis: subxiphoid versus right thoracic approaches.
Article in Journal of thoracic disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Perioperative efficacy of subxiphoid and intercostal thoracoscopic thymectomy: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2026Pooled it
- Comparison of subxiphoid vs intercostal VATS approaches for anterior mediastinal tumors: a retrospective cohort study with focus on elderly patients.European journal of medical research · 2025Article
- Pre-thymectomy disease severity predicts outcome in acetylcholine receptor antibody-positive generalised myasthenia gravis.Journal of neurology · 2024Article
- Choosing the proper path: outcomes of subxiphoid vs. lateral intercostal approaches in the resection of anterior mediastinal masses.Frontiers in surgery · 2024Article
- Physiological and pathological roles of the thymus and value of thymectomy in myasthenia gravis: a narrative review.Mediastinum (Hong Kong, China) · 2024Review
- Subxiphoid-subcostal versus transthoracic thoracoscopic thymectomy: A safe and feasible approach.JTCVS techniques · 2022Article
- Subxiphoid-subcostal thoracoscopic thymectomy for seropositive myasthenia offers equivalent remission rates and potentially faster recovery.Interactive cardiovascular and thoracic surgery · 2022Article
- Subxiphoid thoracoscopic thymectomy for myasthenia gravis.Interactive cardiovascular and thoracic surgery · 2022Article
- Neurological outcomes of extended thymectomy for thymomatous myasthenia gravis: Subxiphoid vs. trans-sternal approaches.Frontiers in surgery · 2022Article
- Effect Evaluation of Subxiphoid and Intercostal Thymectomy: A Meta-Analysis and Systematic Review.Frontiers in surgery · 2022Review
- Feasibility of Video-Assisted Thoracoscopic Surgery via Subxiphoid Approach in Anterior Mediastinal Surgery: A Meta-Analysis.Frontiers in surgery · 2022Article
- Minimally invasive thymectomy for myasthenia gravis: a 7-year retrospective study.Gland surgery · 2021Article
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundApproaches of thoracoscopic thymectomy for myasthenia gravis (MG) are debatable. The subxiphoid approach is widely utilized recent years for its better visualization of the anterior mediastinum. In the present study, we compared perioperative outcomes and mid-term effects of the extended thymectomy for MG between the subxiphoid approach and the routine right-thoracic approach.
methodsOne hundred and thirty-one MG patients treated with thoracoscopic extended thymectomy were analyzed. Among them, 68 patients were operated on via the subxiphoid approach and the other 63 via the conventional right-side unilateral approach. The patient outcomes were retrospectively reviewed and evaluated. Mid-term clinical outcome was assessed according to the classification system proposed by the Myasthenia Gravis Foundation of America (MGFA). Clinical efficacy and variables influencing outcome were evaluated by the Kaplan-Meier method and Cox proportional hazards regression analysis.
resultsCompared with the right thoracic approach, the duration of the procedure via the subxiphoid approach was significantly shorter (P=0.035), the rates of total thymectomy were higher (P=0.028), and the pain scores on postoperative days 1, 3, and 7 were significantly lower (P<0.001, P<0.001, and P=0.03, respectively). A total of 112 patients with MG were followed up. The subxiphoid approach group reported higher rates of complete stable remission (CSR) and effective treatment of MG, although these differences were not statistically significant (Z=-0.484, P=0.627). By multivariate Cox proportional hazards modes analysis, the chance of CSR was significantly increased when age <40 (OR: 2.623, 95% CI: 1.150-5.983, P=0.022), non-thymomatous MG (OR: 1.078, 95% CI: 1.101-3.316, P=0.021) and MGFA clinical classification (OR: 2.024, 95%:1.164-3.523, P=0.013).
conclusionsThe subxiphoid approach has shorter operation time, higher rates of total thymectomy and better quality of life compared with the lateral thoracoscopic approach. Preoperative age, pathological diagnoses and MGFA Clinical Classification are the independent risk factors for non-complete stable remission (NCSR) after thymectomy.
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