Jens C Rückert1, Marc Swierzy, Mahmoud Ismail. 1. Department of General, Visceral, Vascular and Thoracic Surgery, Universitätsmedizin Berlin, Charité Campus Mitte, Berlin, Germany. jens-c.rueckert@charite.de
Abstract
OBJECTIVE: Radical thymectomy has become more popular in the comprehensive treatment of myasthenia gravis. Minimally invasive techniques are increasingly used for thymectomy. The most recent development in robotic thoracoscopic surgery has been successfully applied for mediastinal pathologies. To establish robotic technique as a standard, the results of high-volume centers and comparison with traditional surgery are mandatory. METHODS: In a retrospective cohort study, the results of 79 thoracoscopic thymectomies (October 1994 to December 2002) were compared with the results of 74 robotic thoracoscopic thymectomies (January 2003 to August 2006). Data from both series were collected prospectively. In both groups, all patients had myasthenia gravis. Both cohorts were compared with respect to severity of disease, gender, age, histology, and postoperative morbidity. All patients were analyzed for quantification of improvement of disease according to the Myasthenia Gravis Foundation of America. RESULTS: There were no differences in age distribution and severity of myasthenia gravis. The dominant histologic finding was follicular hyperplasia of the thymus in both groups with a significantly higher percentage in the thoracoscopic thymectomy series (68% vs 45%, P < .001). After a follow-up of 42 months, the cumulative complete remission rate of myasthenia gravis for robotic and nonrobotic thymectomy was 39.25% and 20.3% (P = .01), respectively. CONCLUSIONS: There is an improved outcome for myasthenia gravis after robotic thoracoscopic thymectomy compared with thoracoscopic thymectomy.
OBJECTIVE: Radical thymectomy has become more popular in the comprehensive treatment of myasthenia gravis. Minimally invasive techniques are increasingly used for thymectomy. The most recent development in robotic thoracoscopic surgery has been successfully applied for mediastinal pathologies. To establish robotic technique as a standard, the results of high-volume centers and comparison with traditional surgery are mandatory. METHODS: In a retrospective cohort study, the results of 79 thoracoscopic thymectomies (October 1994 to December 2002) were compared with the results of 74 robotic thoracoscopic thymectomies (January 2003 to August 2006). Data from both series were collected prospectively. In both groups, all patients had myasthenia gravis. Both cohorts were compared with respect to severity of disease, gender, age, histology, and postoperative morbidity. All patients were analyzed for quantification of improvement of disease according to the Myasthenia Gravis Foundation of America. RESULTS: There were no differences in age distribution and severity of myasthenia gravis. The dominant histologic finding was follicular hyperplasia of the thymus in both groups with a significantly higher percentage in the thoracoscopic thymectomy series (68% vs 45%, P < .001). After a follow-up of 42 months, the cumulative complete remission rate of myasthenia gravis for robotic and nonrobotic thymectomy was 39.25% and 20.3% (P = .01), respectively. CONCLUSIONS: There is an improved outcome for myasthenia gravis after robotic thoracoscopic thymectomy compared with thoracoscopic thymectomy.
Authors: Nicholas R Hess; Inderpal S Sarkaria; Arjun Pennathur; Ryan M Levy; Neil A Christie; James D Luketich Journal: Ann Cardiothorac Surg Date: 2016-01
Authors: Bryan M Burt; Xiaopan Yao; Joseph Shrager; Alberto Antonicelli; Sukhmani Padda; Jonathan Reiss; Heather Wakelee; Stacey Su; James Huang; Walter Scott Journal: J Thorac Oncol Date: 2016-08-24 Impact factor: 15.609