Perioperative risk factors for occurrence of myasthenia gravis after thymectomy in patients with thymoma

作者：Xin Zhang, Bin Li, Jianyong Zou, Chunhua Su, Haoshuai Zhu, Ting-Fei Chen, Honghe Luo, Zhenguang Chen, Shuishen Zhang · 发表于：Interactive Cardiovascular and Thoracic Surgery · 年份：2020 · DOI：10.1093/icvts/ivaa133 · 被引用次数：7 · 研究领域：Myasthenia Gravis and Thymoma、Lymphatic Disorders and Treatments、Thyroid and Parathyroid Surgery

OBJECTIVES: The goal of this study was to identify the relationship between clinical characteristics and the occurrence of postoperative myasthenia gravis (PMG) in patients with thymomas and to further identify the relationship between PMG and prognosis. METHODS: Thymoma patients who had surgery at the First Affiliated Hospital of Sun Yat-sen University between July 2004 and July 2016 were reviewed and those who had no previous symptoms of myasthenia gravis were selected for further investigation. In total, 229 patients were included in the study; their clinical characteristics were gathered and analysed. RESULTS: Among the 229 patients, 19 (8.3%) had PMG. The time between the operation and the onset of myasthenia gravis was 134 days on average (range 2-730 days). Patients experiencing PMG showed a lower rate of complete thymoma resection (73.7% vs 91.4%; P = 0.014) and total thymectomy (63.2% vs 82.9%; P = 0.035) compared with those who did not. Univariable and multivariable logistic regression revealed that thymomectomy [odds ratio (OR) 2.81, 95% confidence interval (CI) 1.02-7.77; P = 0.047] and incomplete tumour resection (OR 3.79, 95% CI 1.20-11.98; P = 0.023) were associated with the occurrence of PMG. Multivariable Cox regression showed that the PMG was not related to overall survival (P = 0.087). CONCLUSIONS: This study revealed that incomplete tumour resection and thymomectomy were independent risk factors for PMG in thymoma patients with no previous history of myast...