Comparison of Conservative Treatment and Thymectomy on Myasthenia Gravis Outcome

Background. A systematic review of the literature was performed to compare long-term outcomes of thymectomy and medical treatment for generalized myasthenia gravis (MG). Methods. A Medline search through June 2015 resulted in 71 studies, 27 of which were selected (10,140 patients: 5,275 thymectomies, 4,865 medication). Results. The 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. Conclusions. Thymectomy is superior to conservative treatment with solely medication on remission in MG. (C) 2016 by The Society of Thoracic Surgeons