OBJECTIVES To compare the perioperative and follow-up outcomes of patients with myasthenia gravis (MG) receiving subxiphoid-subcostal or unilateral thoracoscopic thymectomy and to identify the factors affecting MG prognosis. METHODS From January 2013 to December 2019, a total of 137 consecutive MG patients received subxiphoid-subcostal thoracoscopic thymectomy (STT, n = 65) or conventional unilateral thoracoscopic thymectomy (UTT, n = 72). The primary outcomes of this study were perioperative complications, duration and expenses of hospitalization, VAS score and complete stable remission (CSR). RESULTS The patients receiving STT had significantly shorter drainage duration and postoperative hospital stay and lower hospitalization expenses (P < 0.01). Pain scores on postoperative Days 1, 3, 7 and 14 were significantly lower in patients undergoing STT (P < 0.01). The average follow-up was 54.3 ± 24.18 months, with a CSR rate of 30.6% and an overall effective rate of 87.3%. Through uni- and multivariable analyses, shorter symptom duration and Myasthenia Gravis Foundation of America (MGFA) class I were independent predictors for CSR in MG patients receiving thymectomy. CONCLUSIONS The present study not only showed that STT was a safe and feasible technique for MG, with a potentially faster postoperative recovery, lower hospitalization expenses, less postoperative pain and equivalent remission rate, but also revealed that shorter symptom duration and MGFA class I were favourable prognostic factors for CSR.

中文翻译：

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剑突下 - 肋下胸腔镜胸腺切除术治疗血清阳性肌无力提供相同的缓解率和可能更快的恢复

目的比较重症肌无力（MG）患者接受剑突下肋下或单侧胸腔镜胸腺切除术的围手术期和随访结果，并确定影响MG预后的因素。方法 2013 年 1 月至 2019 年 12 月，共有 137 例连续 MG 患者接受剑突下-肋下胸腔镜胸腺切除术（STT，n = 65）或常规单侧胸腔镜胸腺切除术（UTT，n = 72）。本研究的主要结果是围手术期并发症、住院时间和费用、VAS 评分和完全稳定缓解 (CSR)。结果接受STT的患者引流时间明显缩短，术后住院时间明显缩短，住院费用降低（P＜0.01）。术后第 1、3 天的疼痛评分，在接受 STT 的患者中，7 和 14 显着降低（P < 0.01）。平均随访54.3±24.18个月，CSR率为30.6%，总有效率为87.3%。通过单变量和多变量分析，较短的症状持续时间和美国重症肌无力基金会 (MGFA) I 类是接受胸腺切除术的 MG 患者 CSR 的独立预测因子。结CSR 的预后因素。6%，总有效率87.3%。通过单变量和多变量分析，较短的症状持续时间和美国重症肌无力基金会 (MGFA) I 类是接受胸腺切除术的 MG 患者 CSR 的独立预测因子。结CSR 的预后因素。6%，总有效率87.3%。通过单变量和多变量分析，较短的症状持续时间和美国重症肌无力基金会 (MGFA) I 类是接受胸腺切除术的 MG 患者 CSR 的独立预测因子。结CSR 的预后因素。