الفهرس 
Factors predicting surgical outcome of thymectomy in myasthenia gravis
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Abstract
Background: Myasthenia gravis (MG) is a disease affecting the neuromuscular junction and manifests as muscular weakness and fatigability. Thymectomy may benefit patients with MG.This operation can be performed through several different approaches. Many studies tried to analyze all factors could affect the outcome after thymectomy to identify which group of patients will benefit from surgery.Patient and methods: one hundred patients underwent thymectomy for myasthenia gravis in the period between June 2019 and November 2020 in Kasr Alainy hospitals were recruited to this study to evaluate predictors of outcome after thymectomy in the management of non thymomatous myasthenia gravis. Preoperative assessment included age, gender, co morbidities, MGFA classification, medication, plasmaphresis, also all patients performed CT chest, EMG and AChR Ab titre. Thymectomy was performed either by transsternal or VATS approach with documentation of the extent of resection; primary outcome was assessment of improvement by MGFA classification and need for medication.Secondary outcome was postoperative complications. Results: Complete stable remission was achieved in 5 patients, clinical and pharmacological improvements were achieved in 71 patients, 21 patients didn{u2019}t improve and only 3 patients worsen after surgery.Improvement rates in early onset of MG, patients didn{u2019}t have preoperative comorbidities and patients to whom extended thymectomy was performed were 79.3%, 77.3 % and 87.3% respectively. Also patients in whom postoperative AChR Ab decreased obviously had significant higher improvement rate. Although severely symptomatic patients had worse outcome, the correlation between preoperative MGFA classification and postoperative outcome was statistically insignificant (p value = 0.07)