Document Type : Research Paper
Authors
1
Endoscopic and Minimally Invasive Research Center, Department of Surgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2
Department of Persian Medicine, School of Persian and Complementary Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
3
Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
4
Department of Neurology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
5
Thoracic sugeon
10.22038/jctm.2025.91254.1510
Abstract
Background: Thymectomy is a cornerstone in the management of myasthenia gravis (MG). Video-assisted thoracoscopic surgery (VATS) offers a minimally invasive alternative to traditional open transsternal thymectomy. However, data on perioperative outcomes in Iran remain limited.
Methods: In this cross-sectional study, 66 MG patients undergoing thymectomy at Mashhad University of Medical Sciences (2005–2024) were included. Patients underwent open surgery (n=44) or VATS (n=22). Perioperative outcomes—including operative time, blood loss, postoperative drainage, ICU and hospital stay, transfusion requirements, cardiovascular complications, and conversion to open surgery—were compared using Mann–Whitney U and chi-square tests.
Results: VATS thymectomy had longer operative times (124.9±9.6 vs. 88.2±6.5 min, P<0.001) but was associated with lower blood loss (252±52 vs. 323±55 mL, P<0.001), reduced postoperative drainage (273±61 vs. 308±53 mL, P=0.006), shorter ICU stay (1.0±0.0 vs. 1.7±0.5 days, P<0.001), shorter total hospital stay (3.0±0.8 vs. 5.9±0.8 days, P<0.001), and fewer patients requiring transfusion (13.6% vs. 20.0%, P=0.23). Cardiovascular complications were rare and comparable (9.1% vs. 8.9%, P>0.999). Two patients (9.1%) in the VATS group required conversion to open surgery.
Conclusions: VATS thymectomy is a safe and effective minimally invasive alternative to open surgery for MG, providing superior short-term perioperative outcomes without increasing complications. These findings support the adoption of VATS in centers with adequate surgical expertise. Multicenter prospective studies are warranted to confirm long-term outcomes and cost-effectiveness.
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