Comparison of Conservative Treatment and?Thymectomy on Myasthenia Gravis?Outcome

摘要

Inclusion CriteriaScreeningStatistical AnalysisResultsOverall Proportion of RemissionOverall Odds of Remission With Thymectomy Compared With MedicationSensitivity Analysis According to Types of Remission DefinitionSensitivity Analysis According to Types of Medication TreatmentA systematic review of the literature was performed to compare long-term outcomes of thymectomy and medical treatment for generalized myasthenia gravis (MG).MethodsA Medline search through June 2015 resulted in 71 studies, 27 of which were selected (10,140 patients: 5,275 thymectomies, 4,865 medication).ResultsThe pooled proportion of remission with thymectomy was 0.31 (95% CI, 0.25–0.37), with conservative treatment it was 0.15 (95% CI, 0.12–0.18). The odds ratio (OR) of remission with thymectomy in comparison with medication alone was 2.44 (95% CI, 1.91–3.12) overall and according to medication type and remission definitions.ConclusionsThymectomy is superior to conservative treatment with solely medication on remission in MG.Cardiothoracic Anesthesiology:The Annals of Thoracic Surgery CME Program is located online at http://www.annalsthoracicsurgery.org/cme/home. To take the CME activity related to this article, you must have either an STS member or an individual non-member subscription to the journal.Surgery is the treatment of choice for generalized myasthenia gravis (MG). Although thymectomy is the current standard, the issues of whether long-term outcomes of conservative treatment are comparable is still under debate.Only a single study [