Thoracoscopy May Be Superior to Sternotomy for Thymoma in MG

Subxiphoid and subcostal arch thoracoscopic resection is less invasive and has good safety and feasibility compared to median sternotomy for thymoma in patients with myasthenia gravis, according to a new study published in the Journal of Surgical Research. However, according to the authors of the study, these findings need to be confirmed in large-scale randomized controlled clinical trials.

To compare the safety and efficacy of subxiphoid and subcostal arch thoracoscopic resection and median sternotomy for thymoma, a team of Chinese researchers led by Zhengwei Zhao, PhD, from the Department of Thoracic Surgery, The Second Affiliated Hospital of Air Force Military Medical University in Xi’an, China conducted a retrospective study in which they analyzed 502 patients with myasthenia gravis who were diagnosed with a thymoma at Tangdu Hospital of the Fourth Military Medical University in Xi’an, China between December 2012 and December 2017.

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Of these, 424 underwent minimally invasive thoracoscopic surgery like subxiphoid and subcostal arch thoracoscopic resection, while 78 underwent a median sternotomy.

The researchers compared the outcomes of surgery between the 2 groups of patients. They reported that all operations were completed successfully and that there were no statistical differences in most postsurgical outcomes. These included the remission of myasthenia gravis and postoperative complications.

However, there were statistically significant differences between the 2 groups in terms of operation time, blood loss during the operation, the duration of chest drainage, the length of hospital stay after surgery, patient satisfaction score, the incidence of complications, and pain scores, with all these factors being more favorable in the minimally invasive surgery group.

The authors concluded, “subxiphoid and subcostal arch thoracoscopic resection is a less invasive procedure with good safety and feasibility as compared with median sternotomy for thymoma with myasthenia gravis.”