الفهرس | Only 14 pages are availabe for public view |
Abstract Background: Myasthenia gravis (MG) is a disease affecting the neuromuscular junction and manifests as muscular weakness and fatigability. Thymectomy may benefit patients with MG and operation can be performed through several different approaches however controversy exists as to which approach and extent of excision yield the best results. Patients and methods: this is a prospective multi-center randomized controlled study involving 40 patients who underwent Thoracoscopic Thymectomy for management of non-thymomatous Myasthenia Gravis during the period from April 2019 to August 2020 in Kasr Al Ainy hospital, the New Kasr Al Ainy (French) hospital, and Al Salam International Hospital.The patients were divided into two groups; group A included 20 patients that underwent simple VATS thymectomy and group B included 20 patients who underwent extended VATS thymectomy. Preoperative, operative and postoperative data were collected and analyzed to compare between the early results of the two techniques including AChR-Ab titre and examination of excised mediastinal fat for ectopic thymic tissue. Results: there were no Intra-operative complications or conversions to an open approach in either group. The operative time was slightly longer in the extended thymectomy group but without statistical significance. The Improvement in post-op MGFA class was more pronounced in the extended group than in the simple group and is statistically significant (P=0.02). The extended thymectomy group showed more improvement in pyridostigmine and prednisone dosage compared to the simple group |