4.3 Article

Assessment of length of stay and cost of minimally invasive versus open thymectomies in patients with myasthenia gravis in Florida

Journal

GLAND SURGERY
Volume 11, Issue 6, Pages 957-962

Publisher

AME PUBL CO
DOI: 10.21037/gs-22-83

Keywords

Thymectomy; video-assisted thoracic surgery (VATS); minimally invasive surgery (MIS); myasthenia gravis (MG); thoracic surgery

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This study compared the perioperative outcomes and cost between open thymectomy and minimally invasive thymectomy for myasthenia gravis. The results showed that patients who underwent minimally invasive thymectomy had a significantly shorter length of stay and a lower, although not significant, overall cost.
Background: Thymectomy has become a standard component in treatment for myasthenia gravis. The best surgical approach is still subject to debate. Minimally invasive surgery may have a lower mortality and morbidity rate, improved cosmetic results, and equivalent efficacy at improving neurologic symptoms to open approaches. We compared the perioperative outcomes and cost between the two techniques. Methods: We queried Florida Inpatient Discharge Dataset for patients who underwent thymectomy and had a primary diagnosis of non-thymomatous myasthenia gravis using International Classification of Diseases (ICD)-9 and ICD-10 codes to carry out this retrospective cohort study. The dates ranged between January 1 51 , 2013, to December 31 51 , 2018. We compared outcomes of patients who underwent minimally invasive thymectomy versus those who had open thymectomy. Results: An open approach was used in 108 patients, whereas a minimally invasive approach was used in 40 patients. Minimally invasive surgery group had a shorter length of stay (3.0 vs. 6.0 days, P<0.001) and had a non-significant lower total cost ($18.4K vs. $22.1K, P=0.186). Aker adjusting for age and Elixhauser score, length of stay for minimally invasive group was 32% (P=0.01) lower compared to the open surgery group. Conclusions: Patients who underwent minimally invasive thymectomy for Myasthenia gravis had a significantly shorter length of stay and a lower, although not significant, overall cost.

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