TY - JOUR
T1 - Outcomes after robotic thymectomy in nonthymomatous versus thymomatous patients with acetylcholine-receptor-antibody-associated myasthenia gravis
AU - Marcuse, Florit
AU - Hoeijmakers, Janneke G.J.
AU - Hochstenbag, Monique
AU - Hamid, Myrurgia Abdul
AU - Keijzers, Marlies
AU - Mané-Damas, Marina
AU - Martinez-Martinez, Pilar
AU - Verschuuren, Jan
AU - Kuks, Jan
AU - Beekman, Roy
AU - van der Kooi, Anneke J.
AU - van Doorn, Pieter
AU - van Es, Michael
AU - Maessen, Jos J.G.
AU - De Baets, Marc H.V.
N1 - Funding Information:
Anneke van der Kooi reports grants from CSL Behring and Prinses Beatrix Spierfonds, outside the submitted work.
Funding Information:
Janneke G.J. Hoeijmakers reports a grant from the Prinses Beatrix Spierfonds (W.OK17–09), outside the submitted work.
Funding Information:
We are grateful to all participating departments in the 60 hospitals in the Netherlands who contributed to this study. Special thanks to all pulmonologists, thoracic surgeons and neurologists who decided to refer their patients for RATS to the MUMC+. We also like to thank all included patients for their participation and consent. Several authors of this publication are members of the Netherlands Neuromuscular Center (NL-NMD) and the European Reference Network for rare neuromuscular diseases EURO–NMD. MM-D is supported by a Kootstra fellowship.
Publisher Copyright:
© 2023 The Author(s)
PY - 2023/5
Y1 - 2023/5
N2 - The aim of this study was to investigate the surgical and long-term neurological outcomes of patients with acetylcholine-receptor-antibody-associated myasthenia gravis (AChR-MG) who underwent robotic thymectomy (RATS). We retrospectively analyzed the clinical-pathological data of all patients with AChR-MG who underwent RATS using the DaVinci® Robotic System at the MUMC+ between April 2004 and December 2018. Follow-up data were collected from 60 referring Dutch hospitals. In total, 230 myasthenic patients including 76 patients with a thymoma (33.0%) were enrolled in this study. Mean follow-up time, procedure time and hospitalization were, respectively 65.7 ± 43.1 months, 111±52.5 min and 3.3 ± 2.2 days. Thymomatous patients had significantly more frequently and more severe complications than nonthymomatous patients (18.4% vs. 3.9%, p<0.001). Follow up data was available in 71.7% of the included patients. The Myasthenia Gravis Foundation of America postintervention score showed any kind of improvement of MG-symptoms after RATS in 82.4% of the patients. Complete stable remission (CSR) or pharmacological remission (PR) of MG was observed in 8.4% and 39.4% of the patients, respectively. Mean time till CSR/PR remission after thymectomy was 26.2 ± 29.2 months. No statistical difference was found in remission or improvement in MGFA scale between thymomatous and nonthymomatous patients. RATS is safe and feasible in patients with MG. The majority of the patients (82.4%) improved after thymectomy. CSR and PR were observed in 8.4% and 39.4% of the patients, respectively, with a mean of 26.2 months after thymectomy. Thymomatous patients had more frequently and more severe complications compared to nonthymomatous patients.
AB - The aim of this study was to investigate the surgical and long-term neurological outcomes of patients with acetylcholine-receptor-antibody-associated myasthenia gravis (AChR-MG) who underwent robotic thymectomy (RATS). We retrospectively analyzed the clinical-pathological data of all patients with AChR-MG who underwent RATS using the DaVinci® Robotic System at the MUMC+ between April 2004 and December 2018. Follow-up data were collected from 60 referring Dutch hospitals. In total, 230 myasthenic patients including 76 patients with a thymoma (33.0%) were enrolled in this study. Mean follow-up time, procedure time and hospitalization were, respectively 65.7 ± 43.1 months, 111±52.5 min and 3.3 ± 2.2 days. Thymomatous patients had significantly more frequently and more severe complications than nonthymomatous patients (18.4% vs. 3.9%, p<0.001). Follow up data was available in 71.7% of the included patients. The Myasthenia Gravis Foundation of America postintervention score showed any kind of improvement of MG-symptoms after RATS in 82.4% of the patients. Complete stable remission (CSR) or pharmacological remission (PR) of MG was observed in 8.4% and 39.4% of the patients, respectively. Mean time till CSR/PR remission after thymectomy was 26.2 ± 29.2 months. No statistical difference was found in remission or improvement in MGFA scale between thymomatous and nonthymomatous patients. RATS is safe and feasible in patients with MG. The majority of the patients (82.4%) improved after thymectomy. CSR and PR were observed in 8.4% and 39.4% of the patients, respectively, with a mean of 26.2 months after thymectomy. Thymomatous patients had more frequently and more severe complications compared to nonthymomatous patients.
KW - Follow-up
KW - Myasthenia gravis
KW - Robotic thymectomy
KW - Thymomas
UR - http://www.scopus.com/inward/record.url?scp=85152682485&partnerID=8YFLogxK
U2 - 10.1016/j.nmd.2023.03.005
DO - 10.1016/j.nmd.2023.03.005
M3 - Article
C2 - 37037051
AN - SCOPUS:85152682485
SN - 0960-8966
VL - 33
SP - 417
EP - 424
JO - Neuromuscular Disorders
JF - Neuromuscular Disorders
IS - 5
ER -