Author: Kang Qi, Bo Wang, Bin Wang, Lian-Bin Zhang and Xiang-Yang Chu
Summary:
Background: Video-assisted thoracoscopic surgery (VATS) thymectomy has become a feasible treatment for myasthenia gravis (MG) in recent years. The objective of the present meta-analysis was to evaluate the perioperative characteristics, safety, and completely stable remission rate in patients with MG who received VATS or open thymectomy (OT).
Methods: We searched PubMed, Embase, ScienceDirect, Web of Science, and CNKI for related articles using combinations of the search terms video-assisted thoracoscopic thymectomy, transsternal thymectomy, and MG. The inter-study heterogeneity was assessed by χ2-based Q statistics, and the extent of inconsistency was generated by I2 statistics.
Results: A total of 12 studies with 1173 patients were included, and there was no difference in the operation time (p-‰=-‰0.08) and ICU time (p-‰=-‰0.14) between the two groups, but VATS thymectomy was associated with less intra-operation blood loss and hospital time (p-‰<-‰0.00001). VATS was also associated with lower rates of total complication (OR =0.59; 95% CI, 0.37-“0.94; p-‰=-‰0.03) and myasthenic crisis (OR = 0.51; 95% CI, 0.28-“0.92; p-‰=-‰0.03), but the rates of pneumonia (OR = 0.59; 95% CI, 0.29-“1.32; p-‰=-‰0.21) and complete remission rate (CSR) (OR = 0.64; 95% CI, 0.38-“1.09; p-‰=-‰0.10) had no obvious differences between the VATS and OT groups.
Conclusion: Patients with MG undergoing VATS thymectomy achieved better surgical outcomes and fewer complications than those who received OT.
