Evidence map›Paper›PMID 36539629›Full record

SynthesisSurgical endoscopy2023

The short and long-term effects of open vs minimally invasive thymectomy in myasthenia gravis patients: a systematic review and meta-analysis.

Yung Lee, Yasith Samarasinghe, Janhavi Patel, Adree Khondker, Tyler McKechnie, Nadeesha Samarasinghe, Christian Finley, Wael Hanna, Yaron Shargall, John Agzarian

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.1field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Minimally invasiveJournal of thoracic disease · 2025
    Article
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  3. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 1 country.

Yung LeeDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Yasith SamarasingheDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada.
Janhavi PatelDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada.
Adree KhondkerFaculty of Medicine, University of Toronto, Toronto, ON, Canada.
Tyler McKechnieDepartment of General Surgery, McMaster University, Hamilton, ON, Canada.
Nadeesha SamarasingheDepartment of General Surgery, University of British Columbia, Vancouver, BC, Canada.
Christian FinleyDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada.
Wael HannaDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada.
Yaron ShargallDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada.
John AgzarianDepartment of Thoracic Surgery, McMaster University, Hamilton, ON, Canada. agzarij@mcmaster.ca.ORCID 0000-0002-6553-1262
McMaster University · CAUniversity of British Columbia · CAUniversity of Toronto · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveThymectomy has been utilized as a treatment for Myasthenia Gravis (MG) for many decades, with both open and minimally invasive surgical (MIS) techniques currently used. Although MIS has shown improved short-term results, long-term effects remain uncertain. This systematic review and meta-analysis aim to compare the post-operative and long-term outcomes of MIS versus open thymectomy in MG patients.

methodsMEDLINE, EMBASE and CENTRAL databases were searched from inception till January 2022 for keywords related to MG and open or MIS thymectomy. Primary outcome was complete stable remission (CSR), and secondary outcomes were clinical improvement, complications, length of stay, operation time, and blood loss. Grading of recommendations, assessment, development, and evaluation was used to assess the certainty of evidence.

results26 studies with 3588 patients were included in the analysis. At 1, 3 and 5 years, there was no statistical difference noted in CSR between open versus MIS thymectomy. However, CSR was improved at 1 year for MIS thymectomy in non-thymomatous MG (P = 0.03). There was no significant difference in rates of partial clinical improvement between techniques at 1-year. Although analyses on length of hospital stay and blood loss showed improvement following MIS thymectomy, operative time was shorter for open thymectomy.

conclusionThis is the first systematic review and meta-analysis assessing long-term effects of MIS versus open thymectomy in MG patients. Given the lack of significant differences noted, either MIS or open thymectomy can be performed, based on surgeon preference. Further high-level, long-term research should be conducted to determine the benefit of each technique.

Indexed as

Myasthenia GravisThymectomyHumansLength of StayMinimally Invasive Surgical ProceduresRemission InductionRetrospective StudiesTreatment OutcomeLong-TermMeta-AnalysisMyasthenia GravisThymectomy

Identifiers

PMID36539629
OpenAlexW4312067357

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.