Clinical Comparative Analyses of Thymectomy Between Subxiphoid and Subcostal Arch Thoracoscopic Resection and Median Sternotomy for the Treatment of Thymoma With Myasthenia Gravis in Chinese Patients

Introduction: This study aims to retrospectively compare the efficacy and safety of sub-xiphoid and subcostal arch thoracoscopic resection (SR) and the median sternotomy (MS) for thymoma with myasthenia gravis (MG) via propensity-matched analysis.Methods: We retrospectively analyzed 502 patients with thymoma and MG in Tangdu Hos-pital of the Fourth Military Medical University from December 2012 to December 2017. The patients were allocated to SR group (n = 424) and MS group (n = 78). Perioperative outcomes were compared between SR group and MS group by using propensity-matched analysis.Results: All SR and MS operations were accomplished successfully. Most postoperative outcomes between the two groups showed no significant difference such as remission of MG and postoperative complication (P > 0.05). There were statistically significant differ-ences between MS group and SR group in operation time [(116.3 +/- 33.7) min versus (52.2 +/- 31.3) min], intraoperative blood loss [(145.2 +/- 26.7) mL versus (51.2 +/- 10.3) mL], chest drainage duration (3.4 d versus 0 d), days of hospital-stay (5.2 d versus 2.7 d), patient satisfaction score (5.9 +/- 2.3 versus 8.7 +/- 1.2), the incidence of complications and pain scores, with all P values < 0.05.Conclusions: This study suggests that subxiphoid and subcostal arch thoracoscopic resec-tion is a less invasive procedure with good safety and feasibility as compared with median sternotomy for thymoma with myasthenia gravis.(c) 2022 Elsevier Inc. All rights reserved.