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Differences of perioperative clinical characteristics in three surgical approaches were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Time to onset of myasthenia gravis (early or late) (<jats:italic>p<\/jats:italic>\u2009=\u20090.018), blood loss (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), duration of operation (<jats:italic>p<\/jats:italic>\u2009=\u20090.031), duration and volume of thoracic drainage (<jats:italic>p<\/jats:italic>\u2009=\u20090.039 and<jats:italic>p<\/jats:italic>\u2009=\u20090.026), length of hospitalization (<jats:italic>p<\/jats:italic>\u2009=\u20090.039), the efficiency of ectopic thymectomy (<jats:italic>p<\/jats:italic>\u2009=\u20090.037), and the detection rate of ectopic thymus in the second quadrant (<jats:italic>p<\/jats:italic>\u2009=\u20090.018) were different among the three surgical approaches. In univariate logistic regression analysis, higher efficiency of ectopic thymectomy were associated with transsternal (OR 2.36, 95% CI 1.32\u20134.22,<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and thoracoscopic subxiphoid approaches (OR 2.07, 95% CI 1.12\u20133.82,<jats:italic>p<\/jats:italic>\u2009=\u20090.033). In the multiple logistic regression analysis, the transsternal approach (OR 2.02, 95% CI 1.10\u20133.71,<jats:italic>p<\/jats:italic>\u2009=\u20090.024) was an independent protective factor for the efficiency of ectopic thymectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Both the right unilateral thoracoscopic and thoracoscopic subxiphoid approaches have advantages over the transsternal approach in short-term postoperative recovery. Transsternal approach is still the best choice for ectopic thymectomy while thoracoscopic subxiphoid approach show the potential as an alternative way.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s13304-022-01295-5","type":"journal-article","created":{"date-parts":[[2022,6,23]],"date-time":"2022-06-23T20:36:31Z","timestamp":1656016591000},"page":"1435-1443","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficiency of ectopic thymectomy by three surgical approaches in non-thymomatous myasthenia gravis"],"prefix":"10.1007","volume":"74","author":[{"given":"Shuishen","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenguang","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chunhua","family":"Su","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Haoshuai","family":"Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beilong","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2915-9272","authenticated-orcid":false,"given":"Jianyong","family":"Zou","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,6,23]]},"reference":[{"issue":"5","key":"1295_CR1","doi-asserted-by":"publisher","first-page":"464","DOI":"10.1097\/WCO.0000000000000473","volume":"30","author":"A Evoli","year":"2017","unstructured":"Evoli A (2017) Myasthenia gravis: new developments in research and treatment. 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