P-227NON-OPERATIVE EXTERNAL FIXATION OF FLAIL CHEST USING VACUUM-ASSISTED THERAPY

Abstract

Objectives: We report our experience with robotic thymectomy in patients with myasthenia gravis (MG) and provide data on the surgical results and neurologic outcomes, as per the Myasthenia Gravis Foundation of America (MGFA) recommendations for MG clinical research standards. The study aims at reporting the surgical and neurological outcomes of patients of MG treated by robotic thymectomy. Methods: Prospective data were collected from 100 patients with myasthenia gravis (age range 15-67 years) with or without a thymoma, who had completed a minimum follow-up of 1 year. All patients were treated with robotic radical thymectomy. The clinical classification, status of preoperative and postoperative therapy, evaluation of post-interventional clinical status, and descriptions of morbidity/mortality were done as per the MGFA recommendations. Univariate and multivariate analysis was done to assess the factors associated with achievement of complete stable remission (CSR). Results: A total of 100 patients were included in this study. Twenty-nine out of 100 patients (29%) with myasthenia gravis had a thymoma. At the last followup, 99 patients were alive. No evidence of tumour recurrence was found in patients with thymoma. The overall CSR rate was 38% with the median time to CSR of 17.5 months (range 11-48 months). The CSR rate for patients with MG with a thymoma was 19%. Factors found to be significantly predicting CSR were young age, lesser severity of MG and non-thymomatous histology. Conclusions: Robotic thymectomy is a technically feasible and safe operation with a low morbidity and short hospitalization. It is associated with good neurological long-term results in terms of both CSR and clinical improvement.