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Early outcomes of video-assisted thoracoscopic resection of thymus in 181 patients with myasthenia gravis: who are the candidates for the next morning discharge?

^a Department of Thoracic Surgery, Istanbul Medical School, Istanbul University, Istanbul, Turkey
^b Department of Anesthesiology, Istanbul Medical School, Istanbul University, Istanbul, Turkey
^c Department of Neurology, Istanbul Medical School, Istanbul University, Istanbul, Turkey

*Corresponding author. Hamidiye Mah, Barisyolu Cad. Agaoglu MyCountry, G/5 No:3, 34782 Çekmekoy, Istanbul, Turkey. Tel.: +905352937760; fax: +902124142285.

E-mail address: atoker{at}istanbul.edu.tr (A. Toker).

The aims of this study are to present the results of videothoracoscopic thymectomy in patients with myasthenia gravis (MG) and to predict the factors affecting the next morning discharge (NMD). This is a retrospective analysis of the prospectively recorded data of 181 consecutive myasthenic patients who underwent videothoracoscopic thymectomy from June 2002 to September 2009. Sixty-one patients (33.7%) were discharged on the next morning. Univariate and multivariate analyses were evaluated to determine the predictors for NMD. Mean calculated variables were: age (29.8 years), duration of symptoms (22.5 months), duration of surgery (51.3 min), postoperative stay (2.1) days, and visual analogue scale (2.1). No mortality occurred. Four patients were required to stay in intensive care unit (ICU) with a mean of 18.6 h. With logistic regression analysis, duration of operation (DoO) was calculated to be the only predictive factor for NMD (P=0.006). Video-assisted thoracoscopic thymectomy (VAT thymectomy) is a safe surgery procedure with a smooth postoperative period for MG. Although a detailed analysis was performed, only DoO was found to be a predictive factor for NMD in MG patients.

Key Words: Thoracoscopic thymectomy; Myasthenia gravis; Discharge