Patients with myasthenia gravis (MG) who underwent minimally invasive thymectomy had shorter lengths of hospital stays than patients with MG who received open surgery, according to a study published in Gland Surgery.

Patients with MG who received minimally invasive surgery (MIS) for thymectomy had a median hospital stay of 3.0 days compared to 6.0 days for patients with MG who received open surgery for thymectomy (P <.001). The mean cost for MIS was also $9746.80 less on average compared to open surgery but the difference was not significant (P =.187).

“Patients who underwent MIS thymectomy for MG had a significantly shorter hospital length of stay and a lower, although not statistically significant, overall cost. After adjusting for age and Elixhauser score, length of stay for the MIS group remained lower compared to the open group,” the study’s authors said.

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The patients in the study who received MIS were generally younger (41.2 years vs 48.5 years; P =.031) and had lower scores on the Elixhauser Comorbidity Index (0.0 vs 0.5; P =.015), a method of categorizing patients’ comorbidities based on International Classification of Diseases-9 and 10 codes.

Since age and Elixhauser scores were different between the MIS and open surgery groups, they were included in a multivariate model predicting length of stay, and patients with MIS were estimated to have a 32% shorter stay.

“Since MG patients are susceptible to respiratory complications, an approach to decrease pain and improve post-operative respiratory mechanics is preferred, and therefore a minimally invasive thymectomy should be pursued when possible,” the authors recommended.

A total of 148 patients with MG receiving thymectomy were included in the study between January 2013 to December 2018: 40 who received MIS and 108 who received open surgery. There was no difference in sex between the 2 groups.


Castillo-Larios R, Hernandez-Rojas D, Spaulding AC, et al. Assessment of length of stay and cost of minimally invasive versus open thymectomies in patients with myasthenia gravis in Florida. Gland Surg. 2022;11(6):957-962. doi:10.21037/gs-22-83