ĐÁNH GIÁ KẾT QUẢ TRUNG HẠN PHẪU THUẬT CẮT TUYẾN ỨC ĐIỀU TRỊ BỆNH NHƯỢC CƠ

Abstract

Objectives: To evaluate the effectiveness of thymectomy by video-assisted thoracoscopic surgery in the treatment of myasthenia gravis. Methods: This is a retrospective study, describing a series of cases conducted at the Department of Thoracic Surgery, Cho Ray Hospital. Results: from January 2020 to January 2024, there were 62 patients including: 33 (53.20%) cases of myasthenia gravis with thymic tumors and 29 (46.80%) cases of myasthenia without thymic tumors. Video-Assisted Thoracoscopic Surgery (VATS): 23 cases, Robot-Assisted Thoraocsopic Surgery (RATS): 39 cases. The mean operation time of the study group was 143.63 ± 40.06 minutes (80 - 270). No complications were noted during surgery. The rate of postoperative complications was 14.5% (9/62), of which: respiratory failure 11.3% and myasthenic crisis 3.2%. The disease improvement rate was 55.7%, no change was 41.4%. The rates of ptosis and dysphagia decreased 12  months after surgery from 45.2% to 30.6% and 8.1% to 3.2%, respectively. 21% of patients had their medication dose reduced after surgery. There was no statistically significant difference in mid-term outcomes between the two groups of myasthenia gravis with tumors and without tumors. Conclusion: Thoracoscopic thymectomy in treatment of myasthenia gravis has good mid-term results, improving disease improvement rates, reducing symptoms and reducing medication dosage after surgery.