Factors predicting surgical outcome of thymectomy in myasthenia gravis

Waleed Adel; Tarek Mohsen; Ehab ElShihy; Ali Hetiba; Alaa Omar

doi:10.53730/ijhs.v6nS4.6563

Authors

Waleed Adel Cardiothoracic surgery department, Faculty of medicine, Cairo University, Egypt
Tarek Mohsen Cardiothoracic surgery department, Faculty of medicine, Cairo University, Egypt
Ehab ElShihy Cardiothoracic surgery department, Faculty of medicine, Cairo University, Egypt
Ali Hetiba
Ali.hetiba@kasralainy.edu.eg
Cardiothoracic surgery department, Faculty of medicine, Cairo University, Egypt
Alaa Omar Cardiothoracic surgery department, Faculty of medicine, Cairo University, Egypt

Keywords:

myasthenia gravis, thymecomy, outcome, AChR Ab, MGFA

Abstract

Aim of the study is to evaluate predictors of outcome after thymectomy in the management of non thymomatous myasthenia gravis. One hundred patients who underwent thymectomy for myasthenia gravis in the period between June 2019 and September 2021 in Kasr Alainy hospitals were recruited to this study.

Preoperative assessment included age, gender, co morbidities, MGFA classification, duration of symptoms from time of diagnosis till surgery, preoperative medication, preoperative plasmapheresis. All patients performed CT chest, electromyography, and acetyl choline receptor antibody titer before and after surgery. Thymectomy was performed either by transsternal or VATS approach with documentation of the extent of resection; primary outcome was assessment of improvement by MGFA classification and need for medication. Secondary outcome was postoperative complications. Complete stable remission was achieved in 5 patients, clinical and pharmacological improvements were achieved in 71 patients, 21 patients didn’t improve and only 3 patients worsen after surgery. Finally, we found that early onset MG, absent preoperative comorbidity, performing extended thymectomy and reduction of postoperative Acetyl choline receptor antibody titer were significant predictors of improvement of MG symptoms after thymectomy.

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