Video-assisted thoracoscopic surgery for thymectomy in myasthenia gravis patients, one year single centre experience

Introduction Objective of our study was to analyse the incidence of complications after thymectomy in patients with myasthenia gravis (MG). Methods Video-assisted thoracoscopic surgery were performed in twenty patients under general anaesthesia and mechanical one-lung ventilation (OLV) with a double-lumen tube (DLT) was used. Rocuronium bromide was administrated in all patients and quantitative neuromuscular monitoring (TOF) was used. Sugammadex was used for the reversal of neuromuscular blockade in all patients. Results Twenty patients with myasthenia gravis underwent surgical thymectomy in the period between May 2022 and April 2023; mean age was 45±17 years and majority were women (65%). The average duration of the operation was 159±53 minutes. Postoperative complications were registered in five patients: two patients required postoperative non-invasive mechanical ventilation due to pneumonia, and 3 patients had wound infection and dehiscence. Spearman's correlation test showed that body weight (p-0,045), duration of illness in years (p-0.009) and the dose of prednisone (p-0.000) have influenced the occurrence of complications, in contrast to the dose of pyridostigmine and the intraoperative dose of rocuronium, where no statistically significant difference ware registered. Discussion Conclusions: Thymectomy is a part of multidisciplinary treatment of patients with MG. The post-operative complication rate is low and based on our results, the average dose of prednisone is the most important factor influencing the occurrence of complications.