ArticleSurgical endoscopy2026
Two-year outcomes after left-sided VATS extended thymectomy for nonthymomatous myasthenia gravis: a single-center retrospective cohort study.
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThymectomy is used in nonthymomatous myasthenia gravis (MG) to improve clinical status and reduce treatment burden. We evaluated 24-month outcomes after left-sided video-assisted thoracoscopic surgery (VATS) extended thymectomy.
methodsThis retrospective cohort included patients treated at National University Hospital, Damascus, from January 2013 to January 2023, with follow-up through January 2025. Patients with thymoma or insufficient 24-month outcome ascertainment were excluded. The primary outcome was minimal manifestations or better (MM-or-better) at 24 months according to MGFA post-intervention status. Longitudinal changes were assessed using Friedman and Cochran's Q tests; baseline associations were explored using univariable analyses.
resultsOf 75 patients screened, 33 were included. Mean age was 31.7 years, and 69.7% were female. MGFA post-intervention status improved over time (p<0.001). MM-or-better was achieved by 60.6% at 12 months and 81.8% at 24 months, including complete stable remission in 33.3%. Median prednisone dose declined from 20 mg/day preoperatively to 0 mg/day by 6 months; prednisone-free status increased to 81.8% at 24 months (p<0.001). Median pyridostigmine dose declined from 180 to 0 mg/day at 24 months (p<0.001). Early postoperative complications occurred in 9.1%, and later neurological events in 6.1%. Univariable logistic regression identified no significant baseline associations.
conclusionLeft-sided VATS extended thymectomy was followed by neurological improvement and lower prednisone and pyridostigmine requirements. Interpretation is limited by the retrospective design, small sample, and absence of a comparison group.
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