Influence of Minimally Invasive Thymectomy on the Subsequent Clinical Course of Myasthenia Gravis
Influence of Minimally Invasive Thymectomy on the Subsequent Clinical Course of Myasthenia Gravis
The aim of this study is to investigate whether minimally invasive thymectomy achieves
 comparable efficacy and safety results compared to open thymectomy in patients with
 myasthenia gravis. The planned investigation is a multicenter observational study based on
 retrospective (present patient data) and prospective data (questionable outcome data).

 Primary hypothesis: Minimally invasive thymectomy is not inferior to open thymectomy in terms
 of efficacy and safety (non-inferiority study).
Based on large cohort studies of the last decades, the thymectomy has become a central
 component of the immunomodulating therapy in MG patients without thymoma detection. Because
 randomized studies were missing, remained a residual uncertainty on the importance of
 Thymectomy. In the study "Randomized Trial of Thymectomy in Myasthenia Gravis" (MGTX-study)
 published 2016 the effectiveness of thymectomy by patients without thymoma detection has been
 indisputable confirmed. A significant improvement of the patient's complaints and the
 reduction of the immunosuppressive drugs were particularly evident by early onset MG (EOMG)
 two to three years after performing a complete resection of the thymic tissue.

 While the MGTX study (with an open operative procedure) was being done, the
 minimally-invasive thymectomy has gained more and more acceptance. From a surgical point of
 view, the minimally invasive thoracoscopic procedure represents a gentler alternative.
 According to the momentaneous clinical-scientific point of view, further studies are
 necessary to compare both procedures. Furthermore, the MGTX study included only patients with
 generalized MG and positive anti-Acetylcholine Receptor (AChR)-antibodies, who were younger
 than 65 years, so that the relevance of thymectomy in other important subgroups, such as late
 onset MG (LOMG), the ocular MG (OMG), as well as the patients without detected antibodies
 (seronegative MG patients), who represent about 10 % of whole population of MG patients, is
 still not clear.
Inclusion Criteria:

 -  Patients with Myasthenia Gravis

 -  Age ≥18 years

 Exclusion Criteria:

 -  a proper communication with the patient is not possible

 -  an informed consent could not be signed

 -  a patient reject a participation or requires breaking up