Myasthenia Gravis, Thymectomy Clinical Trial
Official title:
Transsternal Versus Transcervical Thymectomy for the Management of Myasthenia Gravis: A Randomized Controlled Trial With a Mean Follow-up of 10 Years
Objective: To comparatively analyze long-term results and complications of transcervical
(TCT) and transsternal thymectomy (TST) in a randomized controlled trial with a mean
follow-up of ten years.
Results: Outcomes 10 years after surgery by MGFA post-intervention status showed that
complete stable remission was achieved in 8 (21.6%) patients of the TCT group, and in 20
patients (55.5%) of the TST group.
Conclusions: Transcervical and transsternal thymectomy are safe and result in significant
improvement of patients with Myasthenia Gravis. TST has superior results in terms of complete
stable remission at 10 years.
Background: Thymectomy is an effective treatment for Myasthenia Gravis in the adult
population. Surgical removal of the thymus can be performed through several approaches.
Comparison of the most commonly used surgical techniques through randomized control trials
with long-term follow-up is scarce.
Objective: To comparatively analyze long-term results and complications of transcervical
(TCT) and transsternal thymectomy (TST) in a randomized controlled trial with a mean
follow-up of ten years.
Results: A total of 100 patients were randomized to transsternal thymectomy (50), and
transcervical procedure (50). There were not significant differences in the demographic
characteristics, MGFA clinical classification, and MGFA therapy status between groups before
surgery. Twenty patients were lost of follow up during the first year and were excluded. Our
final group included 40 patients in each group. Three patients in TCT group (7.5%) and 6
patients in the TST group (15%) developed surgical complications. At 1 year of follow-up, 7
patients (17.5%) of the TCT group were asymptomatic in comparison with 15 patients (37.5%) of
group TST, after 10 years of follow-up, 26 cases (72.9%) in group TCT were asymptomatic in
comparison with 29 cases (80.5%) of group TST. Outcomes 10 years after surgery by MGFA
post-intervention status showed that complete stable remission was achieved in 8 (21.6%)
patients of the TCT group, and in 20 patients (55.5%) of the TST group.
Conclusions: Transcervical and transsternal thymectomy are safe and result in significant
improvement of patients with Myasthenia Gravis. TST has superior results in terms of complete
stable remission at 10 years.
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