[Pubmed] Surgical treatment of myasthenia gravis: 10 years of single center experience

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Front Neurol. 2025 Aug 7;16:1595927. doi: 10.3389/fneur.2025.1595927. eCollection 2025.

ABSTRACT

OBJECTIVE: To evaluate a 10-year experience in the surgical treatment of patients with myasthenia gravis, focusing on clinical and pharmacological outcomes.

METHODS: A retrospective single-center study was conducted based on prospective data collection from the Redcap® maintained by the Thoracic Surgery Department in a Brazilian tertiary hospital. Patients with myasthenia gravis (AchR positive), who underwent surgical treatment as an adjuvant to clinical therapy were included.

RESULTS: The study comprised 85 patients with a mean age of 43 years; 75% were female. Regarding the type of surgery, 24.7% underwent sternotomy and 75.3% minimally invasive approach. The median hospital stay was 4.0 days (p25 = 3.0; p75 = 5.5), and the median ICU stay was 1.0 days (p25 = 0.40, p75 = 2). Postoperative outcomes showed a corticosteroid reduction in 52 participants (61%), and 30 (35%) showed anticholinesterase reduction. The median dose of corticosteroids before surgery was 40.00 mg, and after surgery, 20.00 (p-value < 0.001). Based on Osserman classification, before surgery, it was observed that 4% had grade I, 15% grade IIa, 32% grade IIb, 31% grade III, and 18% grade IV. After surgery, it was observed that 28.5% were asymptomatic, 28% had grade I, 34% had grade IIa, 3.6% had grade IIb, and 5.9% had grade III. There was no statistical difference in clinical and pharmacological response in the analysis with and without thymoma and myasthenia (p-value 0.403; p-value 0.104). About the surgical approach, patients undergoing thymectomy by sternotomy have longer hospital and ICU stays with statistical significance (p-value

Source: https://pubmed.ncbi.nlm.nih.gov/4085252 ... t9+e462414