Literature DB >> 35800735

Assessment of length of stay and cost of minimally invasive versus open thymectomies in patients with myasthenia gravis in Florida.

Rocio Castillo-Larios1, Daniel Hernandez-Rojas1, Aaron C Spaulding2, Alejandra Yu Lee-Mateus1, Priyanka Pulipaka1, Dorin T Colibaseanu2,3, Mathew Thomas4, Sebastian Fernandez-Bussy1, Ian A Makey4.   

Abstract

Background: Thymectomy has become a standard component in treatment for myasthenia gravis. The best surgical approach is still subject to debate. Minimally invasive surgery may have a lower mortality and morbidity rate, improved cosmetic results, and equivalent efficacy at improving neurologic symptoms to open approaches. We compared the perioperative outcomes and cost between the two techniques.
Methods: We queried Florida Inpatient Discharge Dataset for patients who underwent thymectomy and had a primary diagnosis of non-thymomatous myasthenia gravis using International Classification of Diseases (ICD)-9 and ICD-10 codes to carry out this retrospective cohort study. The dates ranged between January 1st, 2013, to December 31st, 2018. We compared outcomes of patients who underwent minimally invasive thymectomy versus those who had open thymectomy.
Results: An open approach was used in 108 patients, whereas a minimally invasive approach was used in 40 patients. Minimally invasive surgery group had a shorter length of stay (3.0 vs. 6.0 days, P<0.001) and had a non-significant lower total cost ($18.4K vs. $22.1K, P=0.186). After adjusting for age and Elixhauser score, length of stay for minimally invasive group was 32% (P=0.01) lower compared to the open surgery group. Conclusions: Patients who underwent minimally invasive thymectomy for Myasthenia gravis had a significantly shorter length of stay and a lower, although not significant, overall cost. 2022 Gland Surgery. All rights reserved.

Entities:  

Keywords:  Thymectomy; minimally invasive surgery (MIS); myasthenia gravis (MG); thoracic surgery; video-assisted thoracic surgery (VATS)

Year:  2022        PMID: 35800735      PMCID: PMC9253185          DOI: 10.21037/gs-22-83

Source DB:  PubMed          Journal:  Gland Surg        ISSN: 2227-684X


  13 in total

1.  Comparative effectiveness and cost-efficiency of surgical approaches for thymectomy.

Authors:  Bartlomiej Imielski; Chitaru Kurihara; Adwaiy Manerikar; Satya Chaudhary; Susan Kosterski; David Odell; Samuel Kim; Ankit Bharat
Journal:  Surgery       Date:  2020-07-05       Impact factor: 3.982

2.  Comparative study for surgical management of thymectomy for non-thymomatous myasthenia gravis from the French national database EPITHOR.

Authors:  Bastien Orsini; Nicola Santelmo; Pierre Benoit Pages; Jean Marc Baste; Marcel Dahan; Alain Bernard; Pascal Alexandre Thomas
Journal:  Eur J Cardiothorac Surg       Date:  2016-03-16       Impact factor: 4.191

Review 3.  Thymectomy for nonthymomatous myasthenia gravis: a critical analysis.

Authors:  Joshua R Sonett; Alfred Jaretzki
Journal:  Ann N Y Acad Sci       Date:  2008       Impact factor: 5.691

4.  Long-term outcome and quality of life after open and thoracoscopic thymectomy for myasthenia gravis: analysis of 131 patients.

Authors:  Kai Bachmann; Doreen Burkhardt; Inken Schreiter; Jussuf Kaifi; Christoph Busch; Gunther Thayssen; Jakob R Izbicki; Tim Strate
Journal:  Surg Endosc       Date:  2008-02-23       Impact factor: 4.584

5.  Minimally invasive thymectomy and open thymectomy: outcome analysis of 263 patients.

Authors:  Julissa Jurado; Jeffrey Javidfar; Alexis Newmark; Matt Lavelle; Matthew Bacchetta; Lyall Gorenstein; Frank D'Ovidio; Mark E Ginsburg; Joshua R Sonett
Journal:  Ann Thorac Surg       Date:  2012-06-28       Impact factor: 4.330

6.  Bilateral thoracoscopic extended thymectomy versus sternotomy.

Authors:  Alfonso Fiorelli; Antonio Mazzella; Roberto Cascone; Francesco Paolo Caronia; Ettore Arrigo; Mario Santini
Journal:  Asian Cardiovasc Thorac Ann       Date:  2016-05-12

7.  Practice advisory: Thymectomy for myasthenia gravis (practice parameter update): Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

Authors:  Gary S Gronseth; Richard Barohn; Pushpa Narayanaswami
Journal:  Neurology       Date:  2020-03-25       Impact factor: 9.910

8.  Comparative clinical outcomes of thymectomy for myasthenia gravis performed by extended transsternal and minimally invasive approaches.

Authors:  Dan M Meyer; Morley A Herbert; Nasin C Sobhani; Paul Tavakolian; Andrea Duncan; Michelle Bruns; Kevin Korngut; Janet Williams; Syma L Prince; L Huber; Gil I Wolfe; Michael J Mack
Journal:  Ann Thorac Surg       Date:  2009-02       Impact factor: 4.330

9.  Thymectomy in nonthymomatous myasthenia gravis - systematic review and meta-analysis.

Authors:  Antônio J M Cataneo; Gilmar Felisberto; Daniele C Cataneo
Journal:  Orphanet J Rare Dis       Date:  2018-06-25       Impact factor: 4.123

Review 10.  International Consensus Guidance for Management of Myasthenia Gravis: 2020 Update.

Authors:  Pushpa Narayanaswami; Donald B Sanders; Gil Wolfe; Michael Benatar; Gabriel Cea; Amelia Evoli; Nils Erik Gilhus; Isabel Illa; Nancy L Kuntz; Janice Massey; Arthur Melms; Hiroyuki Murai; Michael Nicolle; Jacqueline Palace; David Richman; Jan Verschuuren
Journal:  Neurology       Date:  2020-11-03       Impact factor: 9.910

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